Galectin 3 : possible tool for early detection of LV diastolic dysfunction in asymptomatic survivors of childhood, adolescent and young adult cancer

Galectin-3 (Gal-3) is an important factor in the pathophysiology of heart failure, mainly due to its role in cardiac fibrosis, inflammation, and ventricular remodeling. It also predicts long-term outcome among patients with HF with preserved ejection fraction (HFpEF). We want to know if there is a relation between the level of Gal-3 and the echocardiographic parameters of the diastolic function.

The study included patients aged 18 years and older, asymptomatic cardiovascular survivors of childhood, adolescent and young adult cancer treated with anthracyclines with or without mediastinal radiotherapy. We collected anthropometric parameters, cardiovascular risk factors and cancer treatment-related characteristics. Gal-3 and NTproBNP serum levels and the echocardiographic diastolic function parameters were assessed. We used Pearson's correlation test to study the relationship between E/e’ratio and Galectin 3 level.

A total of 30 survivors from childhood, adolescence and young adulthood cancer were included. The sex ratio was 2. The mean age of the patients was 24.9 years, the mean time since completion of cancer treatment was 13.5 years, the mean cumulative doses of anthracyclines and mediastinal radiotherapy were successively 276.67 ± 89.07 mg/m2 and 25 ± 7.07 Gy. Mean Galectin 3 was 9.24 ± 2.61 ng/ml and mean NT-proBNP was 96.8 ng/ml. Mean GLS was 19.3 ± 3.25% and mean LVEF 61.3 ± 5.95%. None of the patients had any known diabetes or treatment to lower blood glucose or blood pressure. No patient had a history of cardiovascular disease. We found a positive significative correlation between the level of Galectin 3 and the E/e’ ratio (r = 0.37 - p = 0.04). No significative correlation was found between NT-proBNP levels and the E/e’ ratio in this study (r = 0.21 - p = 0.26).

Our results suggest that Galectin 3 could be use as a possible tool for early detection of LV diastolic dysfunction in asymptomatic longterm survivors of childhood, adolescent and young adult cancer. Prospective studies with larger numbers are needed to confirm these findings.