IJCS | Volume 32, Nº2, March/April 2019

153 Antunes et al. Galectin-3, myocardial fibrosis and hypertrophic cardiomyopathy Int J Cardiovasc Sci. 2019;32(2)152-157 Original Article myocardial collagen expression and interstitial fibrosis. 12,13 Recent studies demonstrate the association between Gal-3 with inflammation and fibrosis, and these pathophysiological processes are related to adverse cardiac remodeling in HF. 14-16 The aim of the present study was to evaluate Gal-3 values ​in patients with HCM and their association to myocardial fibrosis. Method Study population Gal-3 plasma concentrations were analyzed in 100 subjects divided into two groups: 50 patients with a diagnosis of HCM and 50 healthy control subjects, whose clinical history showed no previous comorbidities, cardiovascular diseases, neoplasms or continuous medication use. The sampling was carried out by convenience. Patients were included consecutively. The inclusion criteria were individuals of both genders, aged between 15 and 65 years, with a previous diagnosis of HCM, established by echocardiography (parietal thickness > 15 mm in any LV segment or ≥ 13 mm in patients with first-degree relatives who had the disease without cavity dilatation and in the absence of any other cardiac or systemic condition that could be the cause of hypertrophy). Exclusion criteria were: known kidney disease (serum creatinine > 2.0 mg/dL), individuals with hepatic cirrhosis of any etiology, patients with kidney or pulmonary fibrosis. All patients with HCM underwent cardiac magnetic resonance imaging (CMRI) aiming at evaluating the presence of myocardial fibrosis detected by the late gadolinium enhancement (LGE) technique. The study was approved by the medical ethics committee of the hospital and performed in accordance with the Declaration of Helsinki. Free and informed consent was obtained in written form from all patients. Galectin-3 measurement Galectin-3 measurements were performed in blood samples, collected after overnight fasting, centrifuged and immediately stored at -80°C. The analysis was performed using the Enzyme-linked Fluorescence Assay (ELFA) (Biomerieux, Marcy-l’Étoile, LY-France). Assay calibration was performed according to the manufacturer’s recommendations. Gal-3 values ≤ 17.8 ng/dL were considered normal. 10 Doppler echocardiogram Transthoracic echocardiography was performed using the Vivid 7 digital ultrasound system (GE Vingmed Ultrasound AS, Horten, Norway). Three cardiac cycles were recorded and digitally stored for further analysis. Left ventricle (LV) and right ventricle (RV) measurements were obtained according to the recommendations of the American Society of Echocardiography. LV ejection fraction (LVEF) was calculated using Simpson’s biplane method. Cardiac magnetic resonance imaging Patients with HCM were submitted to CMR using a GE Signa 1.5-T system (Waukesha, Wisconsin). Cardiac images were obtained in the short and long axis in apnea and with pulse sequences synchronized with the electrocardiogram. To identify myocardial fibrosis using the late enhancement technique, 0.2 mmol/ kg of gadolinium-based contrast was administered intravenously (Dotarem ® , gadoteric acid - Gd-DOTA, Guerbet Aulnay-Sous-Bois – France ). Statistical analysis Statistical analyses were performed using the SPSS software (Statistical Package for Social Science) for Windows, version 20 (SPSS Inc., Chicago, IL, USA). In the descriptive analysis, the variableswere expressed as absolute (N) and relative (%) frequencies andmean and standard deviation for continuous variables. The Kolmogorov-Smirnov test was performed to evaluate the normal distribution of data. The Mann- Whitney test was used to compare the possible differences between the HCM groups, and the Student’s t-test for independent sample was performed to compare the means of the groups. A level of significance of 5% (p value < 0.05) was considered in the statistical analysis. Results The study included 100 subjects divided into two groups, 50 HCM patients and 50 healthy control subjects. The groups were similar regarding age and