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GALECTIN -3

MEDIC. GALECTIN -3. MAI QUANG VINH LONG, MD. CASE. A 53 y.o . man presents with increased shortness of breath on exertion for 2 months.

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GALECTIN -3

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  1. MEDIC GALECTIN -3 MAI QUANG VINH LONG, MD

  2. CASE • A 53 y.o. man presents with increased shortness of breath on exertion for 2 months. • Known for heart failure 2 months ago, sometimes had angina. Smoked 10 cigarettes a day for 20 years. No history of myocardial infarction.No family history of CAD. • P/E: Pulse 72bpm, BP 105/60mmHg, systolic apical murmur 3/6 , lung auscultation is normal , unremarkable abdominal exam and no peripheral oedema

  3. Treatment • Spironolactone 50mg • Losartan 50mg • Bisoprolol 5mg • Acenocoumarol 4mg • Atorvastatin 20mg

  4. AFTER 2 MONTHS AFTER 3 MONTHS

  5. GALECTIN-3Biomarker of myocardial fibrosis

  6. GALECTIN-3 • Galectin-3 is a protein- secreted by activated macrophages- that modulates several physiological and pathological processes at contribute to HF, including fibrosis, or stiffening, in the heart muscle, which impairs the heart’s ability to pump. • Galectin-3 is recommended for additive risk stratification in patients hospitalized with acute decompensated HF as well as in ambulatory patients with chronic stable HF • Persistently elevated galectin-3 predicts new-onset HF 

  7. Biomarkers Indications for Use In Heart Failure Other biomarkers of injury or fibrosis include soluble ST2 receptor, galectin-3. 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure

  8. Khuyến cáo của Hội tim mạch quốc gia Việt Nam về chẩn đoán và điều trị suy tim: Cập nhật 2018

  9. Khuyến cáo của Hội tim mạch quốc gia Việt Nam về chẩn đoán và điều trị suy tim: Cập nhật 2018

  10. CARDIAC FIBROSIS MANAGEMENT • Galectin-3 Inhibitors • Angiotensin receptor blockers (ARBs) :candesartan and losartan • ACE inhibitors : lisinopril • Aldosterone antagonists: Spironolactone and eplerenone

  11. KEY POINTS • Galectin-3 is a mediator of cardiac fibrogenesis, which leads to development and worsening of heart failure • Knowing the level of galectin-3, can assist in optimization of patient management and selection of the appropriate treatment options. • Cardiac fibrosis management: ACE, ARB, Aldosterone antagonists

  12. REFERENCES • 1. Sharma uC, Pokharel s, van Brakel TJ, van BerloJH,Cleutjens JP, schroen B, et al. galectin-3 marks activated macrophages in failure-prone hypertrophied hearts andcontributes to cardiac dysfunction. Circulation. 2004;110:3121–8.2. Van kimmenade RR, JanuzziJlJr, ellinor PT, sharmauC,Bakker JA, low Af, et al. utility of amino-terminal probrainnatriuretic peptide, galectin-3, and apelin for the evaluation of patients with acute heart failure. J Am Coll Cardiol.2006;48:1217–24.3. lokdJA, van dermeer P, Bruggink-André de la Porte PW,lipsic e, van Wijngaarden J, HillegeJl, et al. Prognostic value of galectin-3, a novel marker of firosis, in patients with chronic heart failure: data from the deAl-Hf study. Clin Res Cardiol. 2010;99:323–8.4. Milting H, ellinghaus P, seewald m, Cakar H, BohmsB,kassner A, et al. Plasma biomarkers of myocardial firosis and remodeling in terminal heart failure patients supported by mechanical circulatory support devices. J Heart lung Transplant. 2008;27:589–96.5. Lin yH, linly, Wu yW, Chienkl, lee Cm, Hsu RB, et al. The relationship between serum galectin-3 and serum markers of cardiac extracellular matrix turnover in heartfailure patients. ClinChimActa. 2009;409:96–9..6.PhạmNguyễnVinh.Khuyến cáo của Hội tim mạch quốc gia Việt Nam về chẩn đoán và điều trị suy tim: Cập nhật 2018

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