Ann Lab Med 2018; 38(4): 306-315  https://doi.org/10.3343/alm.2018.38.4.306
Galectin-3 Reflects the Echocardiographic Grades of Left Ventricular Diastolic Dysfunction
Uzair Ansari, M.D.1*, Michael Behnes, M.D.1*, Julia Hoffmann, M.S.1, Michele Natale, M.S.1, Christian Fastner, M.D.1, Ibrahim El-Battrawy, M.D.1, Jonas Rusnak, M.D.1, Seung-Hyun Kim, M.D.1, Siegfried Lang, Ph.D.1, Ursula Hoffmann, M.D.1, Thomas Bertsch, M.D.2, Martin Borggrefe, M.D.1, and Ibrahim Akin, M.D. 1
First Department of Medicine1, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany: DZHK (German Center for Cardiovascular Research) partner site Mannheim; Institute of Clinical Chemistry, Laboratory Medicine and Transfusion Medicine2, General Hospital Nuremberg, Paracelsus Medical University, Nuremberg, Germany
Corresponding author: Uzair Ansari
University Medical Center Mannheim, First Department of Medicine, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
Tel: +49-621-383-5229
Fax: +49-621-383-2012
E-mail: uzair.ansari@umm.de
*These authors contributed equally to this study.
Received: July 26, 2017; Revised: October 19, 2017; Accepted: January 15, 2018; Published online: July 1, 2018.
© Korean Society for Laboratory Medicine. All rights reserved.

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Abstract
Background: The level of Galectin-3 (Gal-3) protein purportedly reflects an ongoing cardiac fibrotic process and has been associated with ventricular remodeling, which is instrumental in the development of heart failure with preserved ejection fraction (HFpEF) syndrome. The aim of this study was to investigate the potential use of Gal-3 in improved characterization of the grades of diastolic dysfunction as defined by echocardiography.
Methods: Seventy HFpEF patients undergoing routine echocardiography were prospectively enrolled in the present monocentric study. Blood samples for measurements of Gal-3 and amino-terminal pro-brain natriuretic peptide (NT-proBNP) were collected within 24 hours pre- or post-echocardiographic examination. The classification of patients into subgroups based on diastolic dysfunction grade permitted detailed statistical analyses of the derived data.
Results: The Gal-3 serum levels of all patients corresponded to echocardiographic indices, suggesting HFpEF (E/A, P =0.03 and E/E’, P =0.02). Gal-3 was also associated with progressive diastolic dysfunction, and increased levels corresponded to the course of disease (P =0.012). Detailed analyses of ROC curves suggested that Gal-3 levels could discriminate patients with grade III diastolic dysfunction (area under the curve [AUC]=0.770, P =0.005).
Conclusions: Gal-3 demonstrates remarkable effectiveness in the diagnosis of patients suffering from severe grade diastolic dysfunction. Increasing levels of Gal-3 possibly reflect the progressive course of HFpEF, as classified by the echocardiographic grades of diastolic dysfunction.
Keywords: Galectin-3, Preserved ejection fraction, NT-proBNP, Diastolic dysfunction



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