A new biomarker that predicts ventricular arrhythmia in patients with ischemic dilated cardiomyopathy: Galectin-3

Galectin-3 (G3) is a biomarker known as an inflammatory state exponent. The aim of this paper was to analyze the G3 in adolescents with ventricular arrhythmia (VES) in order to evaluate its impact on myocardial tissue preservation. The study group (SG) consisted of 25 VES adolescents. The control group (CG) was 21 healthy children. G3 was assessed in the SG and CG. In the SG electrocardiography, Holter monitoring, echocardiography and CMR were performed. The G3 in SG was 13.45 ± 11.4 ng/mL and in CG 7.2 ± 2.0 ng/mL, p < 0.001. Moderate positive correlation between the G3 and z-score of the left ventricular diameter (r = 0.47, p = 0.041) and moderate negative correlation between the G3 and the left ventricular ejection fraction in cardiac magnetic resonance (CMR EF) (−0.49, p = 0.032) were found. According to the multiple linear regression analysis, CMR EF and VES were independent predictors for G3 elevation. Conclusion: Galectin-3 plasma concentration is elevated and correlates with the chosen left ventricular dysfunction parameters in adolescents suffering from ventricular arrhythmia. Further investigation is necessary to establish if elevated G3 is a useful biomarker for screening young individuals with ventricular arrhythmia who are at risk of structural cardiovascular pathology.

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Abstract 17492: Extent and Pattern of Late Gadolinium Enhancement Predict Arrhythmic Events in Patients With Nonischemic Dilated Cardiomyopathy

Circulation ◽

10.1161/circ.132.suppl_3.17492 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Dong Geum Shin ◽

Hye-Jeong Lee ◽

Junbeom Park ◽

Young Jin Kim ◽

Jae-Sun Uhm ◽

...

Keyword(s):

Late Gadolinium Enhancement ◽

Ventricular Arrhythmia ◽

Dilated Cardiomyopathy ◽

Cardiac Death ◽

Primary Outcome ◽

Multivariable Analysis ◽

Gadolinium Enhancement ◽

Nonischemic Dilated Cardiomyopathy ◽

The Impact

Background: Late gadolinium enhancement (LGE) by cardiac MR (CMR) has been related to adverse clinical outcomes in patients with nonischemic dilated cardiomyopathy (NIDC). But, a statistically significant association between LGE and arrhythmic risk in NIDC has not been demonstrated consistently. This study evaluated the impact of the presence, location and pattern of LGE on arrhythmic risk prediction in NICM. Methods: This study included 365 patients (54±15years) with NICM who underwent CMR. The extent, location and pattern of LGE were categorized. We analyzed for the primary outcome of ventricular arrhythmia (VA) including sustained or nonsustained ventricular tachycardia (VT), appropriate implantable cardioverter-defibrillator (ICD) intervention and ventricular fibrillation (VF). Cardiac death and hospitalization for heart failure (HF) were evaluated as secondary outcomes. Results: LGE was seen in 267 (73 %) patients. During median follow-up of 44±36 months, patients with LGE had higher incidence of cardiac death (15 % vs. 2 %, p<0.001), hospitalization for HF (40 % vs. 15 %, p<0.001) and VA (14% vs. 6%, p=0.03). In multivariable analysis, the presence of LGE (HR 2.78; 95% CI 1.10-7.02; p=0.03) was the independent predictor of arrhythmias. Patients with extensive LGE had higher VA (32% vs. 10%, p<0.001) with lower cumulative survival free of VA than those without extensive LGE (p=0.001). The frequent LGE location was as follows: LV septum 64%, LV-RV junction 42% and inferior 10%. VA was lower in patients with than without localized LGE limited to LV-RV junction (21% vs. 46%, p=0.005). Interestingly, while the incidence of ventricular arrhythmia was higher in patients with transmural LGE (29% vs. 10%, p=0.003), it was lower in those with patch LGE (2% vs. 16%, p=0.02) than the other patients. Conclusions: In patients with NICM, the LGE was an independent prognostic predictor of VA. Extensive LGE and specific location of LGE was related with the arrhythmic events.

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1299Late gadolinium enhancement was associated with fragmented QRS of inferior ECG leads, which could predict ventricular arrhythmia in patients with dilated cardiomyopathy

EP Europace ◽

10.1093/ehjci/eux155 ◽

2017 ◽

Vol 19 (suppl_3) ◽

pp. iii256-iii256

Author(s):

J. Park

Keyword(s):

Ventricular Arrhythmia ◽

Dilated Cardiomyopathy ◽

Gadolinium Enhancement ◽

Fragmented Qrs ◽

Ecg Leads

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Serum Galectin-3 and ST2 as predictors of unfavorable outcome in stable dilated cardiomyopathy patients

Hellenic Journal of Cardiology ◽

10.1016/j.hjc.2017.03.006 ◽

2017 ◽

Vol 58 (5) ◽

pp. 350-359 ◽

Cited By ~ 11

Author(s):

Celina Wojciechowska ◽

Ewa Romuk ◽

Ewa Nowalany-Kozielska ◽

Wojciech Jacheć

Keyword(s):

Dilated Cardiomyopathy ◽

Unfavorable Outcome ◽

Galectin 3

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The Recurrence and Frequency of Ventricular Arrhythmia are Lower in Women than in Men with Dilated Cardiomyopathy and Implantable Cardioverter Defibrillators

EP Europace ◽

10.1016/j.eupc.2005.08.220 ◽

2005 ◽

Vol 7 ◽

pp. S23-S24

Author(s):

E HATZINIKOLAOUKOTSAKOU ◽

G BOBOTIS ◽

D TZIAKAS ◽

A HOTIDIS ◽

D FLOROS ◽

...

Keyword(s):

Ventricular Arrhythmia ◽

Dilated Cardiomyopathy ◽

Implantable Cardioverter Defibrillators ◽

Cardioverter Defibrillators

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What is the Diagnosis?

Journal of Cardiac Arrhythmias ◽

10.24207/jca.v32i2.993_in ◽

2019 ◽

Vol 32 (2) ◽

pp. 132-135

Author(s):

Cristiano de Oliveira Dietrich

Keyword(s):

Ventricular Arrhythmia ◽

Dilated Cardiomyopathy ◽

Class Ii ◽

Functional Class ◽

Male Gender

Patient from the male gender, 60 years of age, referred for ablation for symptomatic ventricular arrhythmia despite treatment with amiodarone. Patient with chronic dilated cardiomyopathy post-myocarditis with optimized therapy and functional class II.

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(Letter to the Editor) Response to: protective role of peroxiredoxin-4 in heart failure

Clinical Science ◽

10.1042/cs20191184 ◽

2020 ◽

Vol 134 (1) ◽

pp. 73-74

Author(s):

Natalia López-Andrés

Keyword(s):

Heart Failure ◽

Dilated Cardiomyopathy ◽

Cardiac Fibroblasts ◽

Direct Consequence ◽

Protective Role ◽

Mitochondrial Proteins ◽

Galectin 3 ◽

Human Cardiac Fibroblasts

Abstract We thank Ahmed et al. for their letter regarding our study ‘Galectin-3 down-regulates antioxidant peroxiredoxin-4 in human cardiac fibroblasts’ [1]. As emphasized by Ahmed et al., Prx-4 levels decrease [2] whereas MFN-2, OPA-1 and PGC-1α levels increase [3] in dilated cardiomyopathy (DCM). Moreover, Gal-3 expression is also increased in DCM [4]. In our study, we showed in vitro that Gal-3 decreased Prx-4 without modifying MFN-2 or PGC-1α levels in human cardiac fibroblasts. Although cardiac Prx-4 decrease could be a direct consequence of Gal-3 effects on cardiac fibroblasts, we cannot exclude the possibility that other factors increase MFN-2, OPA-1 and PGC-1α levels in both cardiac fibroblasts or cardiomyocytes in the context of DCM. Further studies are needed to clarify the association between Prx-4 decrease and the increase in other mitochondrial proteins in DCM.

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P1113Patchy localisation of late gadolinium enhancement associated with ventricular arrhythmia in dilated cardiomyopathy

EP Europace ◽

10.1093/europace/euaa162.043 ◽

2020 ◽

Vol 22 (Supplement_1) ◽

Author(s):

V Pooranachandran ◽

A Mistry ◽

Z Vali ◽

X Li ◽

B Sidhu ◽

...

Keyword(s):

Late Gadolinium Enhancement ◽

High Risk ◽

Ventricular Arrhythmia ◽

Dilated Cardiomyopathy ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Lv Function ◽

Gadolinium Enhancement ◽

Ventricular Ejection Fraction ◽

Significant Difference

Abstract Funding Acknowledgements None Introduction Myocardial fibrosis detected using late gadolinium enhancement(LGE) on cardiac magnetic resonance(CMR) imaging holds prognostic value in dilated cardiomyopathy(DCM). Recent reports have demonstrated the localisation of LGE to be promising predictors of ventricular arrhythmic (VA).Aim: To determine the localisation of LGE associated with high risk of VA in DCM patients. Methods: Retrospective review of consecutive DCM patients(n = 85) implanted with an implantable cardioverter defibrillator(ICD) at a single tertiary centre between 2011-2018. All patients with insufficient follow-up data, cardiac channelopathies, primary valvular pathology and congenital heart disease were excluded from analysis(n = 11). Details of VA occurrence were obtained from medical and pacing notes. VA was defined as VA causing haemodynamic compromise or appropriate device therapy (anti-tachycardia pacing/shock). Localisation of LGE was defined as midwall, patchy, subepicardial or transmural. Left ventricular ejection fraction(LVEF) <35% was defined as severely impaired function. Results:74 DCM patients implanted with an ICD were identified for analysis; LGE was observed in 18(60%) VA and 29(66%) non-VA patients(p = 0.6). There was no observed difference in mean age for patients with and without LGE (68 ± 10 vs. 65 ± 10 years,p = 0.07). A significant difference was seen between localisation and VA (p = 0.04), with patchy LGE demonstrating a higher arrhythmic risk(p = 0.005). There was no association between LVEF and LGE(p = 0.2) however, a significant difference was seen in LVEF and arrhythmic risk, with a more severely impaired LV function seen in patients without VA(p = 0.01). Conclusion:This study has demonstrated a patchy LGE localisation to be strongly associated with ventricular arrhythmia in DCM. Whilst this is a valuable tool in risk stratification, a prospective study with a larger population is required to confirm the validity of this finding. Moreover, an additional method will need to be considered to identify high risk patients without LGE. Ventricular Arrhythmia (n = 30) No Ventricular Arrhythmia (n = 44) P Value Male(%) 20(67%) 24(55%) p = 0.29 Age(Mean ± SD) 65 ± 12 65 ± 10 p = 0.36 LGE Midwall 10(56%) 24(83%) p = 0.04 Subepicardial 1(5.5%) 2(7%) p = 0.85 Transmural 1(5.5%) 2(7%) p = 0.85 Patchy 6(33%) 1(3%) p = 0.005 LVEF <35% 23(77%) 42(95%) p = 0.01

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Osteopontin and galectin-3 as biomarkers of maladaptive right ventricular remodeling in pulmonary hypertension

Biomarkers in Medicine ◽

10.2217/bmm-2021-0009 ◽

2021 ◽

Author(s):

Stanislav Keranov ◽

Oliver Dörr ◽

Leili Jafari ◽

Christoph Liebetrau ◽

Till Keller ◽

...

Keyword(s):

Pulmonary Hypertension ◽

Right Ventricular ◽

Dilated Cardiomyopathy ◽

Ventricular Hypertrophy ◽

Ventricular Remodeling ◽

Left Ventricular ◽

Potential Biomarker ◽

Lv Remodeling ◽

Galectin 3 ◽

Right Ventricular Remodeling

Aim: This study assessed the utility of osteopontin (OPN) and galectin-3 (Gal-3) as biomarkers of maladaptive right ventricular remodeling in pulmonary hypertension (PH). Materials & methods: We examined plasma levels of OPN and Gal-3 in patients with PH (n = 62), dilated cardiomyopathy (n = 34), left ventricular hypertrophy (LVH; n = 47), and controls without right ventricle (RV) or LV abnormalities (n = 38). Results: OPN and Gal-3 levels were higher in PH, dilated cardiomyopathy and LVH than in the controls. OPN concentrations in PH patients with maladaptive RV were significantly higher than in those with adaptive RV. Gal-3 did not differentiate between adaptive and maladaptive RV remodeling in PH. OPN and Gal-3 levels did not correlate with parameters of LV remodeling. Conclusion: OPN is a potential biomarker of RV maladaptation.

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