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Association between novel biomarkers of cardiac fibrosis and renal function in patients with heart failure

Session Poster session 6

Speaker Evangelos Oikonomou

Event : ESC Congress 2016

  • Topic : heart failure
  • Sub-topic : Chronic Heart Failure - Other
  • Session type : Poster Session

Authors : E Oikonomou (Athens,GR), G Siasos (Athens,GR), S Tsalamandris (Athens,GR), C Chrysohoou (Athens,GR), A Miliou (Athens,GR), C Mpiri (Athens,GR), A Antonopoulos (Athens,GR), T Zografos (Athens,GR), M Vavuranakis (Athens,GR), D Tousoulis (Athens,GR)

E. Oikonomou1 , G. Siasos1 , S. Tsalamandris1 , C. Chrysohoou1 , A. Miliou1 , C. Mpiri1 , A. Antonopoulos1 , T. Zografos1 , M. Vavuranakis1 , D. Tousoulis1 , 1Hippokration Hospital, University of Athens, 1st Department of Cardiology - Athens - Greece ,

European Heart Journal ( 2016 ) 37 ( Abstract Supplement ), 1120-1121

Background: Elevated circulating levels of galectin-3, a mediator of fibrogenesis, are associated with left ventricular remodeling and adverse outcome in heart failure (HF). Renal function impairment and inflammation further deteriorates clinical outcome in HF patients.

Purpose: To investigate whether biomarkers of renal function and left ventricle loading may be associated with myocardial fibrosis, measured by galectin-3 levels, in patients with ischemic HF.

Methods: We consecutive enrolled 115 subjects with stable ischemic HF of NYHA status II and III. We measured serum Galectin-3 as a fibrogenesis marker, b-type natriuretic peptide (BNP) as an index of left ventricle loading condition, neutrophil gelatinase-associated lipocalin (NGAL) as an early marker of kidney injury and tumor necrosis factor alpha (TNFa) as a well established inflammatory marker. Creatinine clearance (eCcl) was estimated using Cockcroft-Gault formula.

Results: Galectin-3 levels were associated with BNP levels (r=0.37, p=0.006), NGAL levels (r=0.40, p=0.001) and inversely associated with eCcl (r=−0.59, p<0.001) while there was no association of galectin-3 levels with left ventricle ejection fraction (rho=−0.03, p=0.77) and TNFa (r=0.24, p=0.1). Galectin-3 levels were also positively associated with age (r=0.38, p<0.001) and were higher in subjects with diabetes mellitus compared to normoglycemic patients [18.05 (15.42–24.85) ng/ml vs. 14.50 (12.40–19.60) ng/ml, p=0.02]. There was no difference in galectin-3 levels between hypertensive and normotensive subjects [17.30 (14.20–21.60) ng/ml vs. 13.50 (11.20–23.35) ng/ml, p=0.22]. As many confounders exist, we applied a linear regression model which revealed that only NGAL levels were independently associated with galectin-3 [b=0.04 95% CI (0.02–0.06), p<0.001].

Conclusions: Galectin-3, a fibrogenesis protein, is elevated in HF patients and is strongly associated with renal injury as it is expressed by NGAL levels. These findings shed some light on the association between cardiac fibrosis and renal function in HF and highlight the importance of renal function monitoring event in patients with stable HF.

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