Baseline and serial measurements of galectin-3 in patients with heart failure: relationship to prognosis and effect of treatment with valsartan in the Val-HeFT
Aims This study was conducted to determine whether galectin‐3, a β‐galactoside‐binding lectin, plays a role in the pathogenesis of heart failure (HF). Methods and results Galectin‐3 was measured at baseline (n = 1650), after 4 months (n = 1346), and after 12 months (n = 1097) in the Valsartan Heart...
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| Veröffentlicht in: | European journal of heart failure 2013-05, Vol.15 (5), p.511-518 |
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| creator | Anand, Inder S. Rector, Thomas S. Kuskowski, Michael Adourian, Aram Muntendam, Pieter Cohn, Jay N. |
| description | Aims
This study was conducted to determine whether galectin‐3, a β‐galactoside‐binding lectin, plays a role in the pathogenesis of heart failure (HF).
Methods and results
Galectin‐3 was measured at baseline (n = 1650), after 4 months (n = 1346), and after 12 months (n = 1097) in the Valsartan Heart Failure Trial (Val‐HeFT). Galectin‐3 levels at baseline ranged from 4.8 to 53 ng/mL. Higher levels were associated with features of worse HF. In a fully adjusted Cox regression model comprising 23 other prognostic variables, baseline galectin‐3 was not associated with the risks of all‐cause mortality, the composite of the first morbid event, or hospitalization for HF. However, when changes in galectin‐3 over time were examined, the increases in galectin‐3 between baseline and 4 months were independently and significantly associated with the risks of subsequent all‐cause mortality, first morbid event, and hospitalizations for HF, even after adjusting for all baseline and concurrent changes in all variables including estimated glomerular filtration rate (eGFR) and NT‐proBNP. The strongest correlate of galectin‐3 levels was eGFR, which accounted for 20% of the variability in galectin‐3 levels at baseline. There was a significant interaction (P = 0.03) between baseline galectin‐3 and the effect of valsartan on hospitalizations for HF. Valsartan caused a significant 44% reduction in hospitalizations for HF in patients with galectin‐3 levels below the median level of 16.2 ng/mL, but not in patients with levels above the median.
Conclusions
Galectin‐3 levels are elevated in a substantial proportion of patients with HF, particularly those with more severe HF and renal dysfunction. Galectin‐3 increased over time in this cohort, and the increase was independently associated with worse outcomes. Valsartan use was associated with a reduction in hospitalizations for HF in patients with low galectin‐3, but not in those with higher levels of galectin‐3. |
| doi_str_mv | 10.1093/eurjhf/hfs205 |
| format | Article |
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This study was conducted to determine whether galectin‐3, a β‐galactoside‐binding lectin, plays a role in the pathogenesis of heart failure (HF).
Methods and results
Galectin‐3 was measured at baseline (n = 1650), after 4 months (n = 1346), and after 12 months (n = 1097) in the Valsartan Heart Failure Trial (Val‐HeFT). Galectin‐3 levels at baseline ranged from 4.8 to 53 ng/mL. Higher levels were associated with features of worse HF. In a fully adjusted Cox regression model comprising 23 other prognostic variables, baseline galectin‐3 was not associated with the risks of all‐cause mortality, the composite of the first morbid event, or hospitalization for HF. However, when changes in galectin‐3 over time were examined, the increases in galectin‐3 between baseline and 4 months were independently and significantly associated with the risks of subsequent all‐cause mortality, first morbid event, and hospitalizations for HF, even after adjusting for all baseline and concurrent changes in all variables including estimated glomerular filtration rate (eGFR) and NT‐proBNP. The strongest correlate of galectin‐3 levels was eGFR, which accounted for 20% of the variability in galectin‐3 levels at baseline. There was a significant interaction (P = 0.03) between baseline galectin‐3 and the effect of valsartan on hospitalizations for HF. Valsartan caused a significant 44% reduction in hospitalizations for HF in patients with galectin‐3 levels below the median level of 16.2 ng/mL, but not in patients with levels above the median.
Conclusions
Galectin‐3 levels are elevated in a substantial proportion of patients with HF, particularly those with more severe HF and renal dysfunction. Galectin‐3 increased over time in this cohort, and the increase was independently associated with worse outcomes. Valsartan use was associated with a reduction in hospitalizations for HF in patients with low galectin‐3, but not in those with higher levels of galectin‐3.</description><identifier>ISSN: 1388-9842</identifier><identifier>EISSN: 1879-0844</identifier><identifier>DOI: 10.1093/eurjhf/hfs205</identifier><identifier>PMID: 23291728</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Aged ; Angiotensin II Type 1 Receptor Blockers - therapeutic use ; Biomarkers ; Cohort Studies ; Double-Blind Method ; Female ; Fibrosis ; Follow-Up Studies ; Galectin 3 - blood ; Heart failure ; Heart Failure - blood ; Heart Failure - drug therapy ; Heart Failure - mortality ; Hospitalization - statistics & numerical data ; Humans ; Male ; Middle Aged ; Natriuretic peptides ; Pathophysiology ; Prognosis ; Proportional Hazards Models ; Risk Factors ; Tetrazoles - therapeutic use ; Time Factors ; Treatment Outcome ; Valine - analogs & derivatives ; Valine - therapeutic use ; Valsartan</subject><ispartof>European journal of heart failure, 2013-05, Vol.15 (5), p.511-518</ispartof><rights>Published on behalf of the European Society of Cardiology. All rights reserved. © 2013 the Authors</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4165-c5fe8ec91253a072434fa57913fe9024a3fa84b50fa56e0810c84d4c67f9b9773</citedby><cites>FETCH-LOGICAL-c4165-c5fe8ec91253a072434fa57913fe9024a3fa84b50fa56e0810c84d4c67f9b9773</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1093%2Feurjhf%2Fhfs205$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1093%2Feurjhf%2Fhfs205$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,1427,27901,27902,45550,45551,46384,46808</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23291728$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Anand, Inder S.</creatorcontrib><creatorcontrib>Rector, Thomas S.</creatorcontrib><creatorcontrib>Kuskowski, Michael</creatorcontrib><creatorcontrib>Adourian, Aram</creatorcontrib><creatorcontrib>Muntendam, Pieter</creatorcontrib><creatorcontrib>Cohn, Jay N.</creatorcontrib><title>Baseline and serial measurements of galectin-3 in patients with heart failure: relationship to prognosis and effect of treatment with valsartan in the Val-HeFT</title><title>European journal of heart failure</title><addtitle>European Journal of Heart Failure</addtitle><description>Aims
This study was conducted to determine whether galectin‐3, a β‐galactoside‐binding lectin, plays a role in the pathogenesis of heart failure (HF).
Methods and results
Galectin‐3 was measured at baseline (n = 1650), after 4 months (n = 1346), and after 12 months (n = 1097) in the Valsartan Heart Failure Trial (Val‐HeFT). Galectin‐3 levels at baseline ranged from 4.8 to 53 ng/mL. Higher levels were associated with features of worse HF. In a fully adjusted Cox regression model comprising 23 other prognostic variables, baseline galectin‐3 was not associated with the risks of all‐cause mortality, the composite of the first morbid event, or hospitalization for HF. However, when changes in galectin‐3 over time were examined, the increases in galectin‐3 between baseline and 4 months were independently and significantly associated with the risks of subsequent all‐cause mortality, first morbid event, and hospitalizations for HF, even after adjusting for all baseline and concurrent changes in all variables including estimated glomerular filtration rate (eGFR) and NT‐proBNP. The strongest correlate of galectin‐3 levels was eGFR, which accounted for 20% of the variability in galectin‐3 levels at baseline. There was a significant interaction (P = 0.03) between baseline galectin‐3 and the effect of valsartan on hospitalizations for HF. Valsartan caused a significant 44% reduction in hospitalizations for HF in patients with galectin‐3 levels below the median level of 16.2 ng/mL, but not in patients with levels above the median.
Conclusions
Galectin‐3 levels are elevated in a substantial proportion of patients with HF, particularly those with more severe HF and renal dysfunction. Galectin‐3 increased over time in this cohort, and the increase was independently associated with worse outcomes. Valsartan use was associated with a reduction in hospitalizations for HF in patients with low galectin‐3, but not in those with higher levels of galectin‐3.</description><subject>Aged</subject><subject>Angiotensin II Type 1 Receptor Blockers - therapeutic use</subject><subject>Biomarkers</subject><subject>Cohort Studies</subject><subject>Double-Blind Method</subject><subject>Female</subject><subject>Fibrosis</subject><subject>Follow-Up Studies</subject><subject>Galectin 3 - blood</subject><subject>Heart failure</subject><subject>Heart Failure - blood</subject><subject>Heart Failure - drug therapy</subject><subject>Heart Failure - mortality</subject><subject>Hospitalization - statistics & numerical data</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Natriuretic peptides</subject><subject>Pathophysiology</subject><subject>Prognosis</subject><subject>Proportional Hazards Models</subject><subject>Risk Factors</subject><subject>Tetrazoles - therapeutic use</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Valine - analogs & derivatives</subject><subject>Valine - therapeutic use</subject><subject>Valsartan</subject><issn>1388-9842</issn><issn>1879-0844</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU1v1DAQhiMEoqVw5Ip85BLqz7XNja26G9ACBwocLW923Lg4yWI7lP4a_ireZumRk0eeZ54Z6a2qlwS_IVizc5jiTefOO5coFo-qU6KkrrHi_HGpmVK1VpyeVM9SusGYSIzp0-qEMqqJpOq0-rO0CYIfANlhhxJEbwPqwaYpQg9DTmh06NoGaLMfaob8gPY2-_vOrc8d6sDGjJz1oUy8RRFCaY9D6vwe5RHt43g9jMmnez84V0QHZY5g82HBbPllQyoeOxwW5A7QNxvqBlZXz6snrvTgxfE9q76uLq8umnrzef3-4t2mbjlZiLoVDhS0mlDBLJaUM-6skJowBxpTbpmzim8FLr8LwIrgVvEdbxfS6a2Wkp1Vr2dvOfjnBCmb3qcWQrADjFMyhHEhCJWCF7Se0TaOKUVwZh99b-OdIdgcMjFzJmbOpPCvjupp28Pugf4XQgHEDNz6AHf_t5nLD82qWX2ZxcdDfMrw-2HOxh9mIZkU5vuntWmWH8WabYhZsr_SBKyw</recordid><startdate>201305</startdate><enddate>201305</enddate><creator>Anand, Inder S.</creator><creator>Rector, Thomas S.</creator><creator>Kuskowski, Michael</creator><creator>Adourian, Aram</creator><creator>Muntendam, Pieter</creator><creator>Cohn, Jay N.</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201305</creationdate><title>Baseline and serial measurements of galectin-3 in patients with heart failure: relationship to prognosis and effect of treatment with valsartan in the Val-HeFT</title><author>Anand, Inder S. ; Rector, Thomas S. ; Kuskowski, Michael ; Adourian, Aram ; Muntendam, Pieter ; Cohn, Jay N.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4165-c5fe8ec91253a072434fa57913fe9024a3fa84b50fa56e0810c84d4c67f9b9773</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Aged</topic><topic>Angiotensin II Type 1 Receptor Blockers - therapeutic use</topic><topic>Biomarkers</topic><topic>Cohort Studies</topic><topic>Double-Blind Method</topic><topic>Female</topic><topic>Fibrosis</topic><topic>Follow-Up Studies</topic><topic>Galectin 3 - blood</topic><topic>Heart failure</topic><topic>Heart Failure - blood</topic><topic>Heart Failure - drug therapy</topic><topic>Heart Failure - mortality</topic><topic>Hospitalization - statistics & numerical data</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Natriuretic peptides</topic><topic>Pathophysiology</topic><topic>Prognosis</topic><topic>Proportional Hazards Models</topic><topic>Risk Factors</topic><topic>Tetrazoles - therapeutic use</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Valine - analogs & derivatives</topic><topic>Valine - therapeutic use</topic><topic>Valsartan</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Anand, Inder S.</creatorcontrib><creatorcontrib>Rector, Thomas S.</creatorcontrib><creatorcontrib>Kuskowski, Michael</creatorcontrib><creatorcontrib>Adourian, Aram</creatorcontrib><creatorcontrib>Muntendam, Pieter</creatorcontrib><creatorcontrib>Cohn, Jay N.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of heart failure</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Anand, Inder S.</au><au>Rector, Thomas S.</au><au>Kuskowski, Michael</au><au>Adourian, Aram</au><au>Muntendam, Pieter</au><au>Cohn, Jay N.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Baseline and serial measurements of galectin-3 in patients with heart failure: relationship to prognosis and effect of treatment with valsartan in the Val-HeFT</atitle><jtitle>European journal of heart failure</jtitle><addtitle>European Journal of Heart Failure</addtitle><date>2013-05</date><risdate>2013</risdate><volume>15</volume><issue>5</issue><spage>511</spage><epage>518</epage><pages>511-518</pages><issn>1388-9842</issn><eissn>1879-0844</eissn><abstract>Aims
This study was conducted to determine whether galectin‐3, a β‐galactoside‐binding lectin, plays a role in the pathogenesis of heart failure (HF).
Methods and results
Galectin‐3 was measured at baseline (n = 1650), after 4 months (n = 1346), and after 12 months (n = 1097) in the Valsartan Heart Failure Trial (Val‐HeFT). Galectin‐3 levels at baseline ranged from 4.8 to 53 ng/mL. Higher levels were associated with features of worse HF. In a fully adjusted Cox regression model comprising 23 other prognostic variables, baseline galectin‐3 was not associated with the risks of all‐cause mortality, the composite of the first morbid event, or hospitalization for HF. However, when changes in galectin‐3 over time were examined, the increases in galectin‐3 between baseline and 4 months were independently and significantly associated with the risks of subsequent all‐cause mortality, first morbid event, and hospitalizations for HF, even after adjusting for all baseline and concurrent changes in all variables including estimated glomerular filtration rate (eGFR) and NT‐proBNP. The strongest correlate of galectin‐3 levels was eGFR, which accounted for 20% of the variability in galectin‐3 levels at baseline. There was a significant interaction (P = 0.03) between baseline galectin‐3 and the effect of valsartan on hospitalizations for HF. Valsartan caused a significant 44% reduction in hospitalizations for HF in patients with galectin‐3 levels below the median level of 16.2 ng/mL, but not in patients with levels above the median.
Conclusions
Galectin‐3 levels are elevated in a substantial proportion of patients with HF, particularly those with more severe HF and renal dysfunction. Galectin‐3 increased over time in this cohort, and the increase was independently associated with worse outcomes. Valsartan use was associated with a reduction in hospitalizations for HF in patients with low galectin‐3, but not in those with higher levels of galectin‐3.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>23291728</pmid><doi>10.1093/eurjhf/hfs205</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | European journal of heart failure, 2013-05, Vol.15 (5), p.511-518 |
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| source | Wiley Free Content; MEDLINE; Wiley Online Library Journals Frontfile Complete; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Aged Angiotensin II Type 1 Receptor Blockers - therapeutic use Biomarkers Cohort Studies Double-Blind Method Female Fibrosis Follow-Up Studies Galectin 3 - blood Heart failure Heart Failure - blood Heart Failure - drug therapy Heart Failure - mortality Hospitalization - statistics & numerical data Humans Male Middle Aged Natriuretic peptides Pathophysiology Prognosis Proportional Hazards Models Risk Factors Tetrazoles - therapeutic use Time Factors Treatment Outcome Valine - analogs & derivatives Valine - therapeutic use Valsartan |
| title | Baseline and serial measurements of galectin-3 in patients with heart failure: relationship to prognosis and effect of treatment with valsartan in the Val-HeFT |
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