Prognostic Value of Galectin-3 after Left Atrial Appendage Occlusion for Predicting Peri-Device Leakage
Echocardiographic detection of residual peri-device leakage (PDL) after percutaneous left atrial appendage occlusion (LAAO) is crucial for managing anticoagulation. Galectin-3, a protein involved in tissue–foreign body interactions, may hold significance in understanding PDL and cardiac tissue remod...
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MDPI AG
2023-11-01
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| Series: | International Journal of Molecular Sciences |
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| Online Access: | https://www.mdpi.com/1422-0067/24/23/16802 |
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| author | Franz Haertel Paul Lustermann Ali Hamadanchi Katja Gruen Jurgen Bogoviku Pawel Aftanski Julian Westphal Laura Baez Marcus Franz P. Christian Schulze Sven Moebius-Winkler |
| author_facet | Franz Haertel Paul Lustermann Ali Hamadanchi Katja Gruen Jurgen Bogoviku Pawel Aftanski Julian Westphal Laura Baez Marcus Franz P. Christian Schulze Sven Moebius-Winkler |
| author_sort | Franz Haertel |
| collection | DOAJ |
| description | Echocardiographic detection of residual peri-device leakage (PDL) after percutaneous left atrial appendage occlusion (LAAO) is crucial for managing anticoagulation. Galectin-3, a protein involved in tissue–foreign body interactions, may hold significance in understanding PDL and cardiac tissue remodeling after LAAO. This study aimed to analyze galectin-3 serum levels in relation to PDL using a novel echo-morphological classification. LAAO eligible patients were included in the study. Galectin-3 serum levels were measured before LAAO, at 45 days (45D), and at 6 months (6M) after the procedure. Transesophageal echocardiography was used to assess LAAO success. A new echo-morphological classification categorized the degree of LAAO into three different types (A: homogenous echodensity, indicating completely thrombosed device; B: inhomogeneous echolucencies (<50% of device); and C: partially thrombosed device with echolucencies > 50%). Among 47 patients, complete LAAO was achieved in 60% after 45D and in 74% after 6M. We observed a significant increase and distribution of serum levels of galectin-3 [ng/mL] after 45D among the three types (baseline: 13.1 ± 5.8 ng/mL; 45D: 16.3 ± 7.2 ng/mL (Type A) vs. 19.2 ± 8.6 ng/mL (Type B) vs. 25.8 ± 9.4 ng/mL (Type C); <i>p</i> = 0.031), followed by a drop in galectin-3 for Types A and B after 6M toward and below the baseline levels (6M: 8.9 ± 3.1 ng/mL (Type A) vs. 12.4 ± 5.5 ng/mL (Type B)), whereas Type C persisted in showing elevated galectin-3 levels compared to all other types (6M: 17.5 ± 4.5 ng/mL (Type C); <i>p</i> < 0.01). Increased galectin-3 serum levels after LAAO likely reflect the transition from thrombus formation to fibrotic scar development in the LAA lumen. Successful occlusion is associated with a time-restricted decrease in galectin-3 levels after 6 months, while relevant PDL leads to persistently elevated levels, making galectin-3 a potential predictor of occlusion success. |
| first_indexed | 2024-03-09T01:49:42Z |
| format | Article |
| id | doaj.art-3ec9ba9afe854719a857c16725234567 |
| institution | Directory Open Access Journal |
| issn | 1661-6596 1422-0067 |
| language | English |
| last_indexed | 2024-03-09T01:49:42Z |
| publishDate | 2023-11-01 |
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| series | International Journal of Molecular Sciences |
| spelling | doaj.art-3ec9ba9afe854719a857c167252345672023-12-08T15:17:12ZengMDPI AGInternational Journal of Molecular Sciences1661-65961422-00672023-11-0124231680210.3390/ijms242316802Prognostic Value of Galectin-3 after Left Atrial Appendage Occlusion for Predicting Peri-Device LeakageFranz Haertel0Paul Lustermann1Ali Hamadanchi2Katja Gruen3Jurgen Bogoviku4Pawel Aftanski5Julian Westphal6Laura Baez7Marcus Franz8P. Christian Schulze9Sven Moebius-Winkler10Department of Internal Medicine I, Cardiology, University Hospital Jena, Am Klinikum 1, 07747 Jena, GermanyDepartment of Internal Medicine I, Cardiology, University Hospital Jena, Am Klinikum 1, 07747 Jena, GermanyDepartment of Internal Medicine I, Cardiology, University Hospital Jena, Am Klinikum 1, 07747 Jena, GermanyDepartment of Internal Medicine I, Cardiology, University Hospital Jena, Am Klinikum 1, 07747 Jena, GermanyDepartment of Internal Medicine I, Cardiology, University Hospital Jena, Am Klinikum 1, 07747 Jena, GermanyDepartment of Internal Medicine I, Cardiology, University Hospital Jena, Am Klinikum 1, 07747 Jena, GermanyDepartment of Internal Medicine I, Cardiology, University Hospital Jena, Am Klinikum 1, 07747 Jena, GermanyDepartment of Internal Medicine I, Cardiology, University Hospital Jena, Am Klinikum 1, 07747 Jena, GermanyDepartment of Internal Medicine I, Cardiology, University Hospital Jena, Am Klinikum 1, 07747 Jena, GermanyDepartment of Internal Medicine I, Cardiology, University Hospital Jena, Am Klinikum 1, 07747 Jena, GermanyDepartment of Internal Medicine I, Cardiology, University Hospital Jena, Am Klinikum 1, 07747 Jena, GermanyEchocardiographic detection of residual peri-device leakage (PDL) after percutaneous left atrial appendage occlusion (LAAO) is crucial for managing anticoagulation. Galectin-3, a protein involved in tissue–foreign body interactions, may hold significance in understanding PDL and cardiac tissue remodeling after LAAO. This study aimed to analyze galectin-3 serum levels in relation to PDL using a novel echo-morphological classification. LAAO eligible patients were included in the study. Galectin-3 serum levels were measured before LAAO, at 45 days (45D), and at 6 months (6M) after the procedure. Transesophageal echocardiography was used to assess LAAO success. A new echo-morphological classification categorized the degree of LAAO into three different types (A: homogenous echodensity, indicating completely thrombosed device; B: inhomogeneous echolucencies (<50% of device); and C: partially thrombosed device with echolucencies > 50%). Among 47 patients, complete LAAO was achieved in 60% after 45D and in 74% after 6M. We observed a significant increase and distribution of serum levels of galectin-3 [ng/mL] after 45D among the three types (baseline: 13.1 ± 5.8 ng/mL; 45D: 16.3 ± 7.2 ng/mL (Type A) vs. 19.2 ± 8.6 ng/mL (Type B) vs. 25.8 ± 9.4 ng/mL (Type C); <i>p</i> = 0.031), followed by a drop in galectin-3 for Types A and B after 6M toward and below the baseline levels (6M: 8.9 ± 3.1 ng/mL (Type A) vs. 12.4 ± 5.5 ng/mL (Type B)), whereas Type C persisted in showing elevated galectin-3 levels compared to all other types (6M: 17.5 ± 4.5 ng/mL (Type C); <i>p</i> < 0.01). Increased galectin-3 serum levels after LAAO likely reflect the transition from thrombus formation to fibrotic scar development in the LAA lumen. Successful occlusion is associated with a time-restricted decrease in galectin-3 levels after 6 months, while relevant PDL leads to persistently elevated levels, making galectin-3 a potential predictor of occlusion success.https://www.mdpi.com/1422-0067/24/23/16802LAA occluder implantationfibrosisatrial fibrillationanticoagulationleft atrial appendageTEE |
| spellingShingle | Franz Haertel Paul Lustermann Ali Hamadanchi Katja Gruen Jurgen Bogoviku Pawel Aftanski Julian Westphal Laura Baez Marcus Franz P. Christian Schulze Sven Moebius-Winkler Prognostic Value of Galectin-3 after Left Atrial Appendage Occlusion for Predicting Peri-Device Leakage International Journal of Molecular Sciences LAA occluder implantation fibrosis atrial fibrillation anticoagulation left atrial appendage TEE |
| title | Prognostic Value of Galectin-3 after Left Atrial Appendage Occlusion for Predicting Peri-Device Leakage |
| title_full | Prognostic Value of Galectin-3 after Left Atrial Appendage Occlusion for Predicting Peri-Device Leakage |
| title_fullStr | Prognostic Value of Galectin-3 after Left Atrial Appendage Occlusion for Predicting Peri-Device Leakage |
| title_full_unstemmed | Prognostic Value of Galectin-3 after Left Atrial Appendage Occlusion for Predicting Peri-Device Leakage |
| title_short | Prognostic Value of Galectin-3 after Left Atrial Appendage Occlusion for Predicting Peri-Device Leakage |
| title_sort | prognostic value of galectin 3 after left atrial appendage occlusion for predicting peri device leakage |
| topic | LAA occluder implantation fibrosis atrial fibrillation anticoagulation left atrial appendage TEE |
| url | https://www.mdpi.com/1422-0067/24/23/16802 |
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