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HelpTest ID GAL3 Galectin-3, Serum
Reporting Name
Galectin-3, SUseful For
Aiding in the prognosis for patients diagnosed with heart failure
Risk-stratification of heart failure patients
An early indication of treatment failure and as a therapeutic target
Specimen Type
Serum RedSpecimen Required
Collection Container/Tube: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
Collection Instructions: Centrifuge and aliquot serum into plastic vial.
Specimen Minimum Volume
0.2 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum Red | Frozen (preferred) | 365 days | |
| Refrigerated | 24 hours |
Reference Values
<24 months: not established
2-17 years: ≤25.0 ng/mL
≥18 years: ≤22.1 ng/mL
Day(s) and Time(s) Performed
Monday; 9 a.m.
Test Classification
This test has been cleared, approved or is exempt by the U.S. Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.CPT Code Information
82777-Galectin-3
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| GAL3 | Galectin-3, S | 62419-7 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 86202 | Galectin-3, S | 62419-7 |
Clinical Information
Heart failure is a complex cardiovascular disorder with a variety of etiologies and heterogeneity with respect to the clinical presentation of the patient. Heart failure is significantly increasing in prevalence with an aging population and is associated with high short- and long-term mortality rate. Over 80% of patients diagnosed and treated for acute heart failure syndromes in the emergency department are readmitted within the forthcoming year, incurring costly treatments and therapies.
The development and progression of heart failure is a clinically silent process until manifestation of the disorder, which typically occurs late and irreversibly into its progression. Mechanistically, heart failure, whether due to systolic or diastolic dysfunction, is thought to progress primarily through adverse cardiac remodeling and fibrosis in response to cardiac injury and/or stress. Galectin-3 is a biomarker that appears to be actively involved in both the inflammatory and some fibrotic pathways.
Galectin-3 is a carbohydrate-binding lectin whose expression is associated with inflammatory cells including macrophages, neutrophils, and mast cells. Galectin-3 has been linked to cardiovascular physiological processes including myofibroblast proliferation, tissue repair, and cardiac remodeling in the setting of heart failure. Concentrations of galectin-3 have been used to predict adverse remodeling after a variety of cardiac insults.
Interpretation
Clinically, galectin-3 concentrations may be categorized into 3 risk categories, substantiated by results from several large chronic heart failure studies:
≤17.8 ng/mL (low risk)
17.9-25.9 ng/mL (intermediate risk)
>25.9 ng/mL (higher risk)
Results should be interpreted in the context of the individual patient presentation. Elevated galectin-3 results indicate an increased risk for adverse outcomes and signal the presence of galectin-3-mediated fibrosis and adverse remodeling. Once galectin-3 concentrations are elevated they are relatively stable over time in the absence of intervention.
Knowledge of a heart failure patient's galectin-3 results may assist in risk stratification and lead to more aggressive management. There are no specific galectin-3 inhibitors available at this time and heart failure patients with elevated galectin-3 concentrations should be treated and monitored according to established guidelines. Angiotensin receptor blockers (ARBs) and aldosterone antagonists are thought to be particularly effective.
A large multicenter, prospective, observational study was conducted to derive the reference intervals for galectin-3 that included 1,092 subjects between the ages of 55 and 80 years without any known cardiac disease (520 males, 572 females). The 97.5th percentile of galectin-3 in that cohort was 22.1 ng/mL. Individuals with concentrations greater than 22.1 ng/mL had a significant association with mortality and New York Heart Association (NYHA) classification. However, this was an older population and definitive evidence of cardiac disease was not documented.
Clinical Reference
1. Van der Velde AR, Meijers WC, Van den Heuvel ER, et al: Determinants of temporal changes in galectin-3 level in the general population: Data of PREVEND. Int J Cardiol 2016;222:385-390. doi: 10.1016/j.ijcard.2016.07.241
2. Mueller T, Gegenhuber A, Leitner I, et al: Diagnostic and prognostic accuracy of galectin-3 and soluble ST2 for acute heart failure. Clin Chim Acta 2016;463:158-164. doi: 10.1016/j.cca.2016.10.034
3. Sudharshan S, Novak E, Hock K, et al: Use of biomarkers to predict readmission for congestive heart failure. Am J Cardiol 2017;119:445-451. doi: 10.1016/j.amjcard.2016.10.022
4. Meijers WC, van der Velde AR, Muller Kobold AC, et al: Variability of biomarkers in patients with chronic heart failure and healthy controls. Eur J Heart Fail 2017;19:357-365. doi: 10.1002/ejhf.669
5. Meeusen JW, Johnson JN, Gray A, et al: Soluble ST2 and galectin-3 in pediatric patients without heart failure. Clin Biochem 2015;Dec;48(18):1337-1340. doi: 10.1016/j.clinbiochem.2015.08.007
Analytic Time
1 dayMethod Name
Enzyme-Linked Immunosorbent Assay (ELISA)
Forms
If not ordering electronically, complete, print, and send a Cardiovascular Test Request Form (T724) with the specimen.