Galectin-3: role in the formation of various hemodynamic phenotypes of heart failure and interaction with some neurohumoral factors

Abstract

Aim. To study the interaction of serum galectin-3 (Gal-3) with fibrogenic factors, cardiac remodeling, as well as parameters of central hemodynamics in various hemodynamic phenotypes of heart failure (HF). Material and methods . A total of 210 male and female patients with HF were examined (mean age 64,1±1,4 years). HF was established on the basis of patient complaints, medical history, physical examination and laboratory tests using the 2016 ESC Chronic Heart Failure Guidelines. In addition to standard diagnostic tests, enzyme immunoassays were performed: serum Gal-3, aldosterone, matrix metalloproteinase 1 (MMP1), tissue inhibitor of matrix metalloproteinase 1 (TIMP1). Results. Patients were divided into two groups: group I (n=59) — patients with HF with reduced ejection fraction (LVEF <40%), group II (n=56) — patients with HF with midrange EF (LVEF 41-49%), group III (n=95) — patients with HF with preserved EF (LVEF >50%). Reference values of studied substances were as follows: Gal-3 — 8,6 [3,7; 11,7] ng/ml; aldosterone — 86,8 [47,8; 199,1] pg/ml; MMP1 — 14,5 [8,5; 18,7] ng/ml; TIMP1 — 87,4 [68,6; 115,2] ng/ml. In patients with HF, the levels of Gal-3, aldosterone and TIMP1 increased with the disease functional class (FC). In patients of group I, it significantly increased by 1,7-2,5 (p<0,01), 4,1-5,9 (p<0,05) and 4,1-5,7 (p<0,05); in group II, 1,8-2,8 (p<0,01), 5,6-6,8 (p<0,01) and 6,1-8,3 (p<0,01); in group III, by 2,1-3,1 (p<0,01), 6,1-6,9 (p<0,01) and 6,8-9,3 times (p<0,01), respectively. A positive correlation was established with FC: in groups I and II, Gal-3 had a significant negative relationship with LVEF (p<0,001; p<0,01, respectively); in group III, Gal-3 had a moderate positive relationship with LV posterior wall thickness (p<0,05), interventricular septum thickness (p<0,05), the left ventricle mass index (p<0,01) and LV relative wall thickness (p<0,01). Conclusion. Levels of Gal-3 and aldosterone increased with HF FC and had a relevant relationship with the activation of some other neurohumoral factors. Gal-3 can be used as an early biomarker of myocardial fibrosis and cardiac remodeling, in predicting and evaluating risk factors, clinical course and outcome of the disease, as well as to assess the effectiveness of treatment in patients with these HF phenotypes.