Abstract 9294: Spironolactone Reduces Galectin-3 Levels in Mildly Symptomatic Systolic Heart Failure Patients

Abstract

Background: Galectin-3, is a biomarker believed to reflect cardiac remodeling and fibrosis in patients with heart failure. Spironolactone, has been reported to reduce fibrosis, improve cardiac function and survival in heart failure patients. Whether spironolactone improves remodeling process by altering galectin-3 is unknown. Methods: 14 patients (ejection fraction ≤35, NYHA class II) being treated with guideline base treatments were enrolled to the study. Baseline echocardiographic measurements were noted and serum samples were obtained for galectin-3 levels. After excluding renal failure and hyperkalemia they were prescribed spironolactone, 25 mg daily. Patients were followed during 3 months for side effects. After the third month of follow up, echocardiographic measurements were repeated and serum samples were recollected for galectin-3 levels. Results: The mean age of the patients was 67±11, 64% of the patients were male. Most of the patients (93%) had ischemic cardiomyopathy. Of all, 14% had diabetes, 71% had hypertension. There was no significant change in left atrial diameter, left atrial volume, left ventricular end systolic diameters and myocardial performance indexes. Comparing to baseline measurements, there were significant improvements in left ventricular ejection fraction (30.3±4.6 vs. 31.3±4.5, p=0.04), left ventricular end diastolic diameter (58.9±0.5 vs. 58.2±0.6, p=0.03), left ventricular end diastolic volume (137.2±16.4 vs. 127.8±20.4, p=0.002), left ventricular end systolic volume (95.4±15.3 vs. 88±16.9, p=0.002). Galectin-3 levels decreased significantly after commencing spironolactone treatment (1.49±0.58 vs. 0.98±0.29 p=0.01). Decrease in galectin-3 levels were significantly correlated with the improvements in the left ventricular end diastolic and end systolic volumes (p=0.01 and p=0.02 respectively). Conclusions: Administration of spironolactone to patients with mildly symptomatic heart failure has beneficial effects on left ventricular remodeling and has a correlation with a significant decrease in serum galectin-3 levels. Spironolactone may improve remodeling by altering galectin-3 levels. Larger studies are necessary to evaluate whether these findings have clinical implications.