Cardiovascular manifestations are prominent in rheumatoid arthritis (RA), and the majority of RA patients suffer from severe morbidity and death due to cardiovascular disease (CVD). A recent article published in Clinical Rheumatology investigated the potential association of elevated levels of galectin-3 with arterial stiffness and coronary microvascular dysfunction in RA patients. Galectin-3 is a β-galactoside–binding lectin and plays a primary role in numerous biological activities including cell growth, apoptosis, pre-mRNA splicing, angiogenesis, differentiation, and transformation,
The cross-sectional study conducted by Dr. Anyfanti and co-researchers involved patients with RA and non-RA individuals with no cardiovascular comorbidities. The subendocardial viability ratio (SEVR), an indication of microvascular myocardial perfusion, and the gold-standard measure of vascular stiffness, pulse wave velocity (PWV), were assessed. The study found a significant elevation in galectin-3 levels in RA patients compared to non-RA individuals (6.9[6.7] vs [4.6]4.7) ng/dl), while a significant decrease in coronary microvascular perfusion was observed in RA patients compared to controls (142.6 ± 22.8 vs 159.7 ± 23.2%). However, there was no significant difference in PWV between the two groups. The researchers revealed that galectin-3 was associated with both PWV and SEVR in univariate analysis. However, after adjusting for cardiovascular risk factors and subclinical inflammation, these correlations were shown to be insignificant.
A 2019 study reported that galectin-3 might be beneficial as an indicator of cardiac function and cardiovascular fibrosis in well-controlled RA patients with low-grade systemic inflammation and longstanding illness. The study found a strong association between galectin-3 and markers of vascular stiffness, atherosclerosis, myocardial blood flow, systemic vascular resistance, and estimated cardiovascular risk in the univariate analysis. Furthermore, an independent correlation was also observed between galectin-3 and both systemic vascular resistance and cardiac output.
The emerging insights into the role of galectin-3 in RA are promising to enhance patient care. Implementing these findings in clinical practice can lead to improved awareness among RA patients about their cardiovascular risk and enable the identification of individuals who require closer monitoring and more proactive treatment for their cardiovascular concerns. However, it is crucial to conduct further investigations involving larger cohorts to validate these findings and gain a better understanding of the precise implications of galectin-3 in the context of RA and CVD.
References
- Anyfanti P, Dimitriadou A, Dara A, Angeloudi E, Gavriilaki E, Nikolaidou B, et al. Circulating levels of galectin-3 and coronary microvascular perfusion in rheumatoid arthritis patients with suppressed inflammation. Clin Rheumatol. 2023 Jul 7.
- Anyfanti P, Gkaliagkousi E, Gavriilaki E, Triantafyllou A, Dolgyras P, Galanopoulou V, et al. Association of galectin-3 with markers of myocardial function, atherosclerosis, and vascular fibrosis in patients with rheumatoid arthritis. Clin Cardiol. 2019 Jan;42(1):62-68.