Favorable Response to CD34+ Cell Therapy Is Associated with a Decrease of Galectin-3 Levels in Patients with Chronic Heart Failure

الملخص EN

Background.

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.

Methods.

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%.

Results.

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 86±23 μmol/L, NT-proBNP 1132 (IQR 350-2279) pg/mL, and LVEF 30±6%.

Gal-3 at baseline and at 3 months did not differ significantly (13.4±5.5 ng/mL vs.

13.1±5.8 ng/mL; p=0.72), and there were no differences in baseline gal-3 with respect to heart failure etiology (15.1±7.2 ng/mL in ICMP vs.

12.7±4.3 ng/mL in DCMP; p=0.12).

Comparing responders (N=49) to nonresponders (N=18), we found no differences in baseline gal-3 (13.6±5.7 ng/mL vs.

13.2±4.9 ng/mL; p=0.80).

However, responders had significantly lower gal-3 at 3-month follow-up (12.1±4.0 ng/mL vs.

15.7±8.4 ng/mL; p<0.05).

Also, responders demonstrated a significant decrease in gal-3 over 3 months, while in nonresponders, an increase in gal-3 occurred (−1.5±5.4 ng/mL vs.

+2.7±4.3 ng/mL; p=0.01).

Conclusions.

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.