Galectin-3 and Heart Failure with Preserved Ejection Fraction: Clarifying an Emerging Relationship

IntroductionHFpEF is one of the leading causes of death whose burden is estimated to expand in the coming decades. This paper examines the relationship between circulating levels of galectin-3, an emerging risk factor for cardiovascular disease, and the clinical diagnosis of HFpEF. MethodsThe authors reviewed peer-reviewed literature and 18 studies met inclusion criteria. Study characteristics, study outcome definitions, assay characteristics, main findings, and measures of association were tabulated and summarized. ResultsFive (1-5) studies found significant associations between galectin-3 and HFpEF diagnosis compared to healthy controls, and one (6) did not. Five studies (7-11) found significant associations between galectin-3 concentration in circulation and severity of diastolic dysfunction. Three studies (12-14) found a statistically significant association between circulating galectin-3 and all-cause mortality or rehospitalization. Two studies (15,16) found levels of circulating galectin-3 to be a statistically significant predictor of later HFpEF onset. Finally, two studies examined whether galectin-3 was associated with incident HFpEF, one (17) found a significant association and the other (18) did not. ConclusionGiven the paucity of effective therapeutics for HFpEF, galectin-3 shows promise as a possible HFpEF-linked biomarker that may, with further study, inform and predict treatment course to reduce morbidity and mortality.