Background/Purpose:

Galectin-3 has emerged as a promising novel biomarker of cardiovascular fibrosis, that can improve cardiovascular risk stratification in high-risk populations. Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by excess cardiovascular risk. We investigated for the first time whether galectin-3 correlates with robust markers of subclinical atherosclerosis, arterial stiffness and myocardial function in patients with RA.

Methods:

Serum levels of galectin-3 were determined by enzyme-linked immunosorbent assay (ELISA) in RA and non-RA individuals. Carotid-femoral pulse wave velocity (PWV) was estimated as the gold-standard measure of arterial stiffness with applanation tonometry. Subclinical atherosclerosis was evaluated by measurement of carotid intima-media thickness (cIMT) from carotid ultrasound. Indices of myocardial blood flow (cardiac output, stroke volume), contractibility (acceleration index, velocity index) and afterload (systemic vascular resistance) were non-invasively assessed with impedance cardiography, which offers continuous, beat-by-beat measurements of central hemodynamics. Cardiovascular risk was estimated from the Framingham Heart Study.

Results:

A total of 124 participants with a mean age of 59.6±11.6 years were studied, of whom 85 were RA patients and 39 controls. Mean DAS score was 3.6±1.2, median disease duration was 10 (5–18) years, and median erythrocyte sedimentation rate was 20 (10–30) mm/hr. Serum galectin-3 was significantly higher in RA patients, compared to the control group [17.7 (9.8 – 33.5) vs 9.1 (6.0 – 12.0) ng/dl, p<0.001]. However, galectin-3 did not significantly differ when the subgroup of patients without cardiovascular comorbidities (n=38) were separately compared to controls [10.7 (6.4–20.3) vs 9.1 (6.0–12.0) ng/dl, p=ns].

In the univariate analysis, galectin-3 significantly correlated with both PWV (r=0.341, p=0.002) and cIMT (r=0.312, p=0.004) among RA patients. An inverse association was found between galectin-3 and stroke volume (r=–0.279, p=0.010), which was even stronger with cardiac output (r=–0.409, p<0.001). Galectin-3 strongly correlated with systemic vascular resistance (r=0.364, p=0.001) and both acceleration index (r=–0.317, p=0.003) and velocity index (r=–0.395, p<0.001). A positive association was observed between galectin-3 and the estimated 10-year cardiovascular risk from the Framingham Heart Study (r=0.379, p=0.001). On the contrary, no associations were found between galectin-3 and disease-related parameters, including inflammation and disease activity. Multivariate analysis revealed an independent association between galectin-3 and cardiac output (beta=–0.274, p=0.039).

Conclusion:

In a relatively well-controlled cohort of RA patients presenting with low-grade systemic inflammation and long-standing disease, serum galectin-3 strongly correlated with markers of cardiac performance and the estimated 10-year cardiovascular risk. By contrast, galectin-3 was not related to inflammation and disease activity in these patients.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/galectin-3-as-a-marker-of-subclinical-atherosclerosis-arterial-stiffness-and-myocardial-performance-in-patients-with-rheumatoid-arthritis/