Galectin 3 is markedly elevated in severe heart failure and predicts improvement in LV volumes post cardiac resynchronisation therapy

Background: Cardiac Resynchronisation Therapy (CRT) is commonly used in the management of patients with heart failure (HF). One-third of CRT recipients do not benefit from CRT. Currently, there are no well-established biomarkers to predict the response to CRT. Galectin-3 has been reported to regulate cardiac remodelling in patients with HF. In this study, we investigated the relationships between: i) galectin-3 levels in HF vs age-matched healthy population; ii) baseline plasma galectin-3 levels and reverse remodelling after CRT. Methods and Results: Plasma galectin-3 levels were compared in 67 patients, age (68±6 yrs), without existing cardiovascular disease or previous antihypertensive therapy and 28 patients (aged 71.2±9.4) with predominantly severe HF (70% NYHA class III or IV) and planned CRT irrespective of the aetiology of HF. There was a significant increase in galectin-3 levels in patients with HF vs healthy ageing. However, there was no relationship between baseline galectin-3 levels and LV volumes in either the healthy ageing cohort or those with HF. Baseline galectin-3 levels correlated with significant improvement in LVESV (p=0.01) and LVEDV (p=0.02) in HF patients post CRT. On multivariate analyses, galectin-3 remained the only independent predictor of the improvements in LVESV (p=0.015) and LVEDV (p=0.02) post-CRT after adjustment for age, gender, NT pro-BNP and NYHA class. Conclusion: Plasma galectin-3 is a promising biomarker of improvement of LV volumes in response to CRT. It has discriminatory potential between patients with severe symptomatic HF and patients with normal physiological change in LV volumes.