Beschreibung:
<jats:p><jats:italic>Background</jats:italic>. Galectin-3 plasma levels (gal-3) were shown to correlate with the scar burden in chronic heart failure (CHF) setting. As scar burden predicts response to stem cell therapy, we sought to explore a correlation between gal-3 and response to CD34+ cell transplantation in patients with CHF. <jats:italic>Methods</jats:italic>. We performed a post hoc analysis of patients, enrolled in 2 prospective trials investigating the clinical effects of CD34+ cell therapy in patients with ischemic cardiomyopathy (ICMP) and nonischemic dilated cardiomyopathy (DCMP). CD34+ cells were mobilized by G-CSF, collected via apheresis, and injected transendocardially using NOGA system. Patients were followed for 3 months and demographic, echocardiographic, and biochemical parameters and gal-3 were analyzed at baseline and at follow-up. Response to cell therapy was defined as an LVEF increase of ≥5%. <jats:italic>Results</jats:italic>. 61 patients were included in the analysis. The mean age of patients was 52 years and 83% were male. DCMP and ICMP were present in 69% and 31% of patients, respectively. The average serum creatinine was <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M1"><mml:mn>86</mml:mn><mml:mo>±</mml:mo><mml:mn>23</mml:mn></mml:math> <jats:italic>μ</jats:italic>mol/L, NT-proBNP 1132 (IQR 350-2279) pg/mL, and LVEF <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M2"><mml:mn>30</mml:mn><mml:mo>±</mml:mo><mml:mn>6</mml:mn></mml:math>%. Gal-3 at baseline and at 3 months did not differ significantly (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M3"><mml:mn>13.4</mml:mn><mml:mo>±</mml:mo><mml:mn>5.5</mml:mn></mml:math> ng/mL vs. <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M4"><mml:mn>13.1</mml:mn><mml:mo>±</mml:mo><mml:mn>5.8</mml:mn></mml:math> ng/mL; <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M5"><mml:mi>p</mml:mi><mml:mo>=</mml:mo><mml:mn>0.72</mml:mn></mml:math>), and there were no differences in baseline gal-3 with respect to heart failure etiology (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M6"><mml:mn>15.1</mml:mn><mml:mo>±</mml:mo><mml:mn>7.2</mml:mn></mml:math> ng/mL in ICMP vs. <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M7"><mml:mn>12.7</mml:mn><mml:mo>±</mml:mo><mml:mn>4.3</mml:mn></mml:math> ng/mL in DCMP; <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M8"><mml:mi>p</mml:mi><mml:mo>=</mml:mo><mml:mn>0.12</mml:mn></mml:math>). Comparing responders (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M9"><mml:mi>N</mml:mi><mml:mo>=</mml:mo><mml:mn>49</mml:mn></mml:math>) to nonresponders (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M10"><mml:mi>N</mml:mi><mml:mo>=</mml:mo><mml:mn>18</mml:mn></mml:math>), we found no differences in baseline gal-3 (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M11"><mml:mn>13.6</mml:mn><mml:mo>±</mml:mo><mml:mn>5.7</mml:mn></mml:math> ng/mL vs. <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M12"><mml:mn>13.2</mml:mn><mml:mo>±</mml:mo><mml:mn>4.9</mml:mn></mml:math> ng/mL; <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M13"><mml:mi>p</mml:mi><mml:mo>=</mml:mo><mml:mn>0.80</mml:mn></mml:math>). However, responders had significantly lower gal-3 at 3-month follow-up (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M14"><mml:mn>12.1</mml:mn><mml:mo>±</mml:mo><mml:mn>4.0</mml:mn></mml:math> ng/mL vs. <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M15"><mml:mn>15.7</mml:mn><mml:mo>±</mml:mo><mml:mn>8.4</mml:mn></mml:math> ng/mL; <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M16"><mml:mi>p</mml:mi><mml:mo><</mml:mo><mml:mn>0.05</mml:mn></mml:math>). Also, responders demonstrated a significant decrease in gal-3 over 3 months, while in nonresponders, an increase in gal-3 occurred (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M17"><mml:mo>−</mml:mo><mml:mn>1.5</mml:mn><mml:mo>±</mml:mo><mml:mn>5.4</mml:mn></mml:math> ng/mL vs. <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M18"><mml:mo>+</mml:mo><mml:mn>2.7</mml:mn><mml:mo>±</mml:mo><mml:mn>4.3</mml:mn><mml:mtext> </mml:mtext></mml:math>ng/mL; <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M19"><mml:mi>p</mml:mi><mml:mo>=</mml:mo><mml:mn>0.01</mml:mn></mml:math>). <jats:italic>Conclusions</jats:italic>. In patients with chronic heart failure undergoing CD34+ cell therapy, a decrease in galectin-3 plasma levels is associated with beneficial response to this treatment modality. Further prospective data is warranted to confirm our findings and to deepen our understanding of the role of gal-3 in the field of stem cell therapy.</jats:p>