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GCC
81981
Galectin-3 is a biomarker which appears to be actively involved in both the inflammatory and fibrotic
pathways that are thought to be involved. 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.
Useful For: An aid in prognosis for patients diagnosed with heart failure Risk-stratification of heart
failure patients An early indication of treatment failure and as a therapeutic target
Interpretation: Clinically, galectin-3 concentrations may be categorized into 3 risk categories,
substantiated by results from several large chronic heart failure studies: (2-4) < or =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 patientâ€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 which included 1,092 subjects between the ages of 55 and 80 years
without any known cardiac disease (520 males, 572 females).(5) The 97.5th percentile of galectin-3 in
that cohort was 22.1 ng/mL. Individuals with concentrations >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.
Reference Values:
< 18 years: Not established
> or =18 years: < or =22.1 ng/mL
Clinical References: 1. Weintraub NL, Collins SP, Pang PS, et al: Acute heart failure syndromes:
emergency department presentation, treatment, and disposition: current approaches and future aims: a
scientific statement from the American Heart Association. Circulation 2010;122:1975-1996 2. Felker GM,
Fiuzat M, Shaw LK, et al: Galectin-3 in Ambulatory Patients With Heart Failure: Results from the
HF-ACTION Study. Circulation 2012 (in press) 3. Lok DJ, Van Der Meer P, de la Porte PW, et al:
Prognostic value of galectin-3, a novel marker of fibrosis, in patients with chronic heart failure: data from
the DEAL-HF study. Clin Res Cardiol 2010 May;99(5):323-328 4. de Boer RA, Lok DJ, Jaarsma T, et al:
Predictive value of plasma galectin-3 levels in heart failure with reduced and preserved ejection fraction.
Ann Med 2011 Feb;43(1):60-68 5. Christenson RH, Duh SH, Wu AH, et al: Multi-center determination of
galectin-3 assay performance characteristics: Anatomy of a novel assay for use in heart failure. Clin
Biochem 2010 May;43(7-8):683-690
Gallstone Cholesterol Content
Clinical Information: Most gallstones are soft, flesh colored, and consist of a high percentage of
cholesterol. Formation of gallstones is the result of the gallbladder breaking down the molecular complex
between bile salts and cholesterol. At this point, the cholesterol deposits about some microscopic nidus to
form gallstones.
Useful For: This assay provides information on the cholesterol content of the gall stones. This test can
aid the physician in designing a strategy for management of the patient's problem when cholecystectomy
would be problematic.
Interpretation: The presence of a high percentage of cholesterol in the gallstone suggests the process
by which the gallstone is formed.
Reference Values:
Not applicable
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