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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. [ABSTRACT FROM AUTHOR]

Introduction: Noncompaction cardiomyopathy (NCC) is a congenital heart disease characterized by an arrest of the myocardial compaction process. Although NCC patients have impaired formation of microvasculature, the functional impact of these changes remains undefined. Hypothesis: We sought to analyze a potential correlation between myocardial ischemia and heart failure progression in patients with NCC. Methods: We enrolled 20 (12 male, 8 female) patients with NCC, diagnosed by cardiac MRI. The average age was 46±15.3 years. Echocardiography was performed to determine left ventricular end diastolic diameter and volume (EDD and EDV), ejection fraction (LVEF), with global longitudinal strain (GLS) postprocessing. At patient inclusion we also measured serum levels of NT-proBNP. Myocardial SPECT was performed at rest and on stress, determining summed difference score (SDS). Significant myocardial ischemia was defined as SDS≥2. Results: Of 20 patients enrolled, 9 patients (45%) had evidence of myocardial ischemia (Group A), 11 patients (55%) showed no significant ischemic changes (Group B). The two groups did not differ in sex (male 67% in Group A vs. 55% in Group B, P=0.58), age (45±14,6 years vs. 46±14,6 years, P=0.92), creatinine (79±14 μmol/L vs. 74±12 μmol/L, P=0.48) or bilirubin (12±7 μmol/L vs. 11±3 μmol/L, P=0.51). When compared to Group B, Group A had significantly higher EDD (6.3±0.9 cm vs. 5.3±0.6 cm, P=0.018), lower NTproBNP levels (1950±2004 pg/mL vs. 294±429 pg/mL in Group B, P=0.02) and a tendency toward lower LVEF (36.6±16.7% vs. 51.8±16.8% in Group B, P=0.06), higher EDV (179.2±53.9 mL vs. 138.7±47.4 mL, P=0.09), and lower GLS (-11.4±7% vs. -15.4±4%, P=0.12). Overall, higher SDS was associated with lower LVEF (r=-0.46, P=0.04), higher EDV (r=0.53, P=0.02), higher levels of NT-proBNP (r=0,82, P<0.001), and a tendency toward lower GLS (r=0.40, P=0.06). Conclusions: In patients with NCC, the presence of myocardial ischemia is associated with worse left ventricular function, dilation of left ventricle and more pronounced neurohumoral activation. Further studies are needed to investigate whether treatment approaches targeting myocardial ischemia, such as CD34+ cell therapy, may halt the progression of disease in this patient cohort. [ABSTRACT FROM AUTHOR]