Prognostic value of galectin-3 and right ventricular function for long-term mortality in heart failure patients treated with cardiac resynchronization therapy

Beata Zaborska,Andrzej Budaj,Ewa Pilichowska-Paszkiet,Grażyna Sygitowicz,Michał Zaborski,Tomasz Słomski,Ewa Makowska

doi:10.1038/s41598-021-00984-2

Beata Zaborska, Andrzej Budaj + Show 5 more

Open Access

https://doi.org/10.1038/s41598-021-00984-2

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Abstract

Recently, associations between the biomarker galectin-3 and numerous pathological processes involved in heart failure (HF) and right ventricular (RV) function have been observed. We aimed to assess the long-term prognostic ability of galectin-3 and RV function parameters for all-cause mortality in HF patients treated with cardiac resynchronization therapy (CRT). We prospectively studied 63 symptomatic HF patients with a left ventricular (LV) ejection fraction (EF) ≤ 35%. The median serum galectin-3 concentration was 13.4 ng/mL (IQR 11.05, 17.15). A detailed assessment of LV and RV geometry and function was performed with echocardiography. CRT defibrillator implantation was achieved in all patients without major complications. The follow-up lasted 5 years. In the multivariable Cox regression model, independent predictors for all-cause mortality were log baseline galectin-3 and baseline RV function expressed as tricuspid annular plane systolic excursion with HR 2.96 (p = 0.037) and HR 0.88 (p = 0.023), respectively. Analysis of subgroups defined by galectin-3 concentration and CRT response showed that patients with high baseline galectin-3 concentrations and a lack of response to CRT had a significantly lower probability of survival. In our patient cohort, the baseline galectin-3 concentration and RV function were independent predictors of long-term all-cause mortality in HFrEF patients following CRT implantation.

Highlights

Associations between the biomarker galectin-3 and numerous pathological processes involved in heart failure (HF) and right ventricular (RV) function have been observed
In our previous study in HF with reduced ejection fraction (HFrEF) patients, we found that Gal-3 was significantly negatively correlated with the echocardiographic parameter of long-axis RV function—tricuspid annular plane systolic excursion (TAPSE)
Four patients died within 6 months after cardiac resynchronization therapy (CRT)-D implantation

Summary

Introduction

Associations between the biomarker galectin-3 and numerous pathological processes involved in heart failure (HF) and right ventricular (RV) function have been observed. We aimed to assess the long-term prognostic ability of galectin-3 and RV function parameters for all-cause mortality in HF patients treated with cardiac resynchronization therapy (CRT). The baseline galectin-3 concentration and RV function were independent predictors of long-term all-cause mortality in HFrEF patients following CRT implantation. The biomarker galectin-3 (Gal-3), a lectin family member, is associated with numerous physiological and pathological processes in HF, including fibrogenesis, inflammation, and ventricular r emodeling[2,3,4]. In our previous study in HFrEF patients, we found that Gal-3 was significantly negatively correlated with the echocardiographic parameter of long-axis RV function—tricuspid annular plane systolic excursion (TAPSE). Elevated Gal-3 concentrations in this population might indicate concomitant RV d ysfunction[17]

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