Galectin-3 is associated with stage B metabolic heart disease and pulmonary hypertension in young obese patients
Journal
Journal of the American Heart Association
Journal Volume
8
Journal Issue
7
Date Issued
2019
Author(s)
Gopal D.M.
Ayalon N.
Siwik D.
Sverdlov A.
Donohue C.
Perez A.
Downing J.
Apovian C.
Silva V.
Panagia M.
Kolachalama V.
Ho J.E.
Liang C.-S.
Gokce N.
Colucci W.S.
Abstract
Background-Obesity is a precursor to heart failure with preserved ejection fraction. Biomarkers that identify preclinical metabolic heart disease (MHD) in young obese patients would help identify high-risk individuals for heart failure prevention strategies. We assessed the predictive value of GAL3 (galectin-3), FSTL3 (follistatin-like 3 peptide), and NT-proBNP (N-terminal pro-B-type natriuretic peptide) to identify stage B MHD in young obese participants free of clinically evident cardiovascular disease. Methods and Results-Asymptomatic obese patients (n=250) and non-obese controls (n=21) underwent echocardiographic cardiac phenotyping. Obese patients were classified as MHD positive (MHD-POS; n=94) if they had abnormal diastolic function or left ventricular hypertrophy and had estimated pulmonary artery systolic pressure ? 35 mm Hg. Obese patients without such abnormalities were classified as MHD negative (MHD-NEG; n=52). Serum biomarkers timed with echocardiography. MHD-POS and MHD-NEG individuals were similarly obese, but MHD-POS patients were older, with more diabetes mellitus and metabolic syndrome. Right ventricular coupling was worse in MHD-POS patients (P<0.001). GAL3 levels were higher in MHD-POS versus MHD-NEG patients (7.7±2.3 versus 6.3±1.9 ng/mL, respectively; P<0.001). Both GAL3 and FSTL3 levels correlated with diastolic dysfunction and increased pulmonary artery systolic pressure but not with left ventricular mass. In multivariate models including all 3 biomarkers, only GAL3 remained associated with MHD (odds ratio: 1.30; 95% CI, 1.01-1.68; P=0.04). Conclusions-In young obese individuals without known cardiovascular disease, GAL3 is associated with the presence of preclinical MHD. GAL3 may be useful in screening for preclinical MHD and identifying individuals with increased risk of progression to obesity-related heart failure with preserved ejection fraction. ? 2019 The Authors.
Subjects
Echocardiography; Obesity; Prevention; Remodeling heart failure
SDGs
Other Subjects
amino terminal pro brain natriuretic peptide; angiotensin receptor antagonist; antihypertensive agent; beta adrenergic receptor blocking agent; dipeptidyl carboxypeptidase inhibitor; follistatin like 3 peptide; galectin 3; insulin; oral antidiabetic agent; peptide derivative; unclassified drug; biological marker; brain natriuretic peptide; follistatin related protein; Fstl3 protein, human; galectin 3; galectin-3, human; peptide fragment; pro-brain natriuretic peptide (1-76); adult; Article; asymptomatic disease; cardiovascular disease; clinical assessment; controlled study; diabetes mellitus; diastolic dysfunction; disease classification; disease marker; female; heart disease; heart left ventricle hypertrophy; heart left ventricle mass; heart right ventricle; human; hypertension; lung artery pressure; major clinical study; male; metabolic disorder; metabolic heart disease; metabolic syndrome X; obesity; phenotype; predictive value; priority journal; protein determination; pulmonary hypertension; systolic blood pressure; transthoracic echocardiography; two dimensional echocardiography; case control study; complication; echocardiography; heart failure; heart left ventricle hypertrophy; hemodynamics; metabolic disorder; metabolism; middle aged; obesity; pathophysiology; physiology; pulmonary hypertension; Adult; Biomarkers; Case-Control Studies; Echocardiography; Female; Follistatin-Related Proteins; Galectin 3; Heart Failure; Hemodynamics; Humans; Hypertension, Pulmonary; Hypertrophy, Left Ventricular; Male; Metabolic Diseases; Middle Aged; Natriuretic Peptide, Brain; Obesity; Peptide Fragments
Publisher
American Heart Association Inc.
Type
journal article