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A Novel BioTarget in Treatment of Heart Failure: Changes in Serum Galectin-3 Levels after Spironolactone Therapy

Abstract

Onur Sinan Deveci, Aziz Inan Çelik, Müslüm Firat Ikikardes, Çaglar Emre Çagliyan, Çaglar Özmen, Ali Deniz, Rabia Eker Akilli, Filiz Kibar, Salih Çetiner, Mesut Demir, Mehmet Kanadasi and Mustafa Demirtas

Object�?±ve: It has been aimed to investigate the Galectin-3 (GAL-3) levels and clinical responses after addition of spironolactone as a mineralocorticoid receptor antagonist (MRA) to the current treatment in patients with heart failure with low ejection fraction who received no aldosterone antagonist therapy previously.

Pat�?±ents and methods: The study included 112 patients with Heart Failure (HF) who showed left ventricular Ejection Fraction (EF) of 35% or below, New York Heart Association (NYHA) Class II-IV symptoms and did not receive MRAs in their current treatment. Serum Gal-3 levels, serum BNP level, 6-minute walk test and class level of NYHA were examined before and 6 months after treatment of spironolactone in all patients.

Results: Mortality developed in 10 of 112 patients. Baseline and 6th month follow-up data obtained from 102 of 112 patients. Mean LVEF (%), BNP levels, Gal-3 levels, NYHA class of functional capacity and mean 6-minute walking test distance of the patients before treatment of spironolactone were 31.3 ± 3.2%, 451,4 ± 50.3 pg/ml, 39 ± 21 ng/ml, 2,8 ± 0.59 and 305 ± 61 m respectively whereas, the same variables were found 32.1 ± 2,8% (p=0.21), 443.6 ± 49 pg/ml (p=0.23), 33 ± 22 ng/ml (p=<0.001), 2,5 ± 0.47 (p=0.037) and 386 ± 87 m (p=<0.001) respectively at 6th follow-up after treatment of spironolactone.

Conclus�?±on: Spironolactone use is associated with regression of Gal-3 along with clinical improvement in HF symptoms. This may suggest that Gal-3 apart from being a biomarker of HF may also be a bio-target in HF management.