Key result
Pre-operative galectin-3 levels ≤18.2 ng/mL were associated with a higher probability of left ventricular reverse remodelling after mitral valve repair (OR 6.58; 95% CI 1.32-33.33; P=0.02).
Why the study?
Does pre-operative galectin-3 level predict left ventricular reverse remodelling after surgical mitral valve repair in heart failure patients with functional mitral regurgitation?
Cohort (n=42)
Does pre-operative galectin-3 level predict left ventricular reverse remodelling after surgical mitral valve repair in heart failure patients with functional mitral regurgitation?
Odds Ratio: 6.58 (95% CI 1.32–33.33)
p-value: p=0.02
High pre-operative plasma galectin-3 levels are independently associated with a lack of left ventricular reverse remodelling after surgical mitral valve repair in heart failure patients.
May inform selection for mitral valve repair in functional MR; hypothesis-generating and requires prospective validation before practice change.
AIMS: Mitral valve repair in patients with functional mitral regurgitation (FMR) has been associated with beneficial left ventricular (LV) reverse remodelling. Recently, galectin-3 emerged as a marker of myocardial inflammation and fibrosis which may influence LV remodelling after surgery. The aim of the current study was to evaluate the association between pre-operative galectin-3 levels and LV reverse remodelling in heart failure patients with significant FMR who underwent mitral valve repair. METHODS AND RESULTS: In total, 42 heart failure patients (66 ± 10 years, 69% male) were evaluated. Plasma galectin-3 levels were assessed pre-operatively. Two-dimensional echocardiographic parameters were measured at baseline, and at 6 and 12 months after surgery. LV reverse remodelling was defined as a decrease in LV end-systolic volume ≥15% at 6 months follow-up. In total, 57% of the patients showed LV reverse remodelling. Patients with LV reverse remodelling showed significantly lower pre-operative galectin-3 levels (17.5 ± 5.6 vs. 23.7 ± 9.9 ng/mL, P = 0.009) compared with patients without LV reverse remodelling. In addition, patients with galectin-3 ≤18.2 ng/mL had a six-fold higher probability of showing LV reverse remodelling after surgery as compared with patients with levels >18.2 ng/mL (odds ratio 6.58, 95% confidence interval 1.32-33.33, P = 0.02). CONCLUSION: High pre-operative plasma galectin-3 is independently associated with the absence of LV reverse remodelling after mitral valve repair. Galectin-3 may be useful to identify heart failure patients who will need additional treatment to obtain beneficial LV reverse remodelling.
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Kortekaas et al. (2013) conducted a cohort in Heart failure with significant functional mitral regurgitation (n=42). Pre-operative galectin-3 ≤18.2 ng/mL vs. Pre-operative galectin-3 >18.2 ng/mL was evaluated on Left ventricular reverse remodelling (decrease in LV end-systolic volume ≥15% at 6 months follow-up) (OR 6.58, 95% CI 1.32-33.33, p=0.02). Pre-operative galectin-3 levels ≤18.2 ng/mL were associated with a higher probability of left ventricular reverse remodelling after mitral valve repair (OR 6.58; 95% CI 1.32-33.33; P=0.02).
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