Background/Aims Galectin-3 plays a key pathogenic role in cardiac hypertrophy and heart failure. The present study aimed to investigate the effects of galectin-3 on cardiomyopathy – related factors and cardiac contractility in a rat model of cirrhotic cardiomyopathy.
Methods Rats were divided into two sets, one for a functional study, the other for cardiac contractile-related protein evaluation. There were four groups in each set: sham operated and sham plus N-acetyllactosamine (N-Lac, a galectin-3 inhibitor; 5 mg/kg); bile duct ligated (BDL) and BDL plus N-Lac. Four weeks after surgery, ventricular level of galectin-3, collagen I and III ratio, tumor necrosis factor alpha (TNFα), and brain natriuretic peptide (BNP) were measured either by Western blots or immunohistochemistry or enzyme-linked immunosorbent assay. Blood pressure was measured by polygraph recorder. Cardiomyocyte contractility was measured by inverted microscopy.
Results Galectin-3 and collagen I/III ratio were significantly increased in cirrhotic hearts. TNFα and BNP were significantly increased in BDL serum and heart compared with sham controls. Galectin-3 inhibitor significantly decreased galectin-3, TNFα, and BNP in cirrhotic hearts but not in sham controls. N-Lac also significantly improved the blood pressure, and systolic and diastolic cardiomyocyte contractility in cirrhotic rats but had no effect on sham controls.
Conclusion Increased galectin-3 in the cirrhotic heart significantly inhibited contractility via TNFα. Inhibition of galectin-3 decreased the cardiac content of TNFα and BNP and reversed the decreased blood pressure and depressed contractility in the cirrhotic heart. Galectin-3 appears to play a pathogenic role in cirrhotic cardiomyopathy.
Citations
Citations to this article as recorded by
Apoptosis in Cardiac Conditions Including Cirrhotic Cardiomyopathy Fengxue Yu, Dae Gon Ryu, Ki Tae Yoon, Hongqun Liu, Samuel S. Lee International Journal of Molecular Sciences.2025; 26(13): 6423. CrossRef
Cirrhotic Cardiomyopathy: Bridging Hepatic and Cardiac Pathophysiology in the Modern Era Dragoș Lupu, Camelia Cornelia Scârneciu, Diana Țînț, Cristina Tudoran Journal of Clinical Medicine.2025; 14(17): 5993. CrossRef
Galectin-3: A Multitasking Protein Linking Cardiovascular Diseases, Immune Disorders and Beyond Mariarosaria Morello, Gisella Titolo, Saverio D’Elia, Silvia Caiazza, Ettore Luisi, Achille Solimene, Chiara Serpico, Andrea Morello, Francesco Natale, Paolo Golino, Plinio Cirillo, Giovanni Cimmino Targets.2025; 3(4): 34. CrossRef
Galectin-3 as a therapeutic target in pulmonary hypertension: Molecular mechanisms, drug development directions, and emerging clinical applications Antonín Sedlář, Pavla Bojarová, František Kolář, Vladimír Křen, Lucie Bačáková Biomedicine & Pharmacotherapy.2025; 193: 118756. CrossRef
Cardiomyopathy in cirrhosis: From pathophysiology to clinical care Hongqun Liu, Jwan A. Naser, Grace Lin, Samuel S. Lee JHEP Reports.2024; 6(1): 100911. CrossRef
Cirrhotic cardiomyopathy: Pathogenesis, clinical features, diagnosis, treatment and prognosis Francisca Almeida, Alexandra Sousa Revista Portuguesa de Cardiologia.2024; 43(4): 203. CrossRef
Therapies for Cirrhotic Cardiomyopathy: Current Perspectives and Future Possibilities Hongqun Liu, Daegon Ryu, Sangyoun Hwang, Samuel S. Lee International Journal of Molecular Sciences.2024; 25(11): 5849. CrossRef
Role of Galectin in Cardiovascular Conditions including Cirrhotic Cardiomyopathy Hongqun Liu, Sang-Youn Hwang, Samuel S. Lee Pharmaceuticals.2023; 16(7): 978. CrossRef
Chenodeoxycholic Acid Improves Embryo Implantation and Metabolic Health through Modulating Gut Microbiota–Host Metabolites Interaction during Early Pregnancy Meixia Chen, Ying Zhao, Haifeng Ji, Lu Li, Hui Liu, Sixin Wang, Dongyan Zhang, Jingdong Yin, Jing Wang, Xin Zhang Antioxidants.2023; 13(1): 8. CrossRef
Temporal profile of cerebrospinal fluid galactin-3 and associated cytokine responses after severe traumatic brain injury in patients: a retrospective study Melisa Cetin, Ping Yip, Zhou-Hao Liu Future Healthcare Journal.2023; 10: S18. CrossRef
Temporal profile of cerebrospinal fluid galactin-3 and associated cytokine responses after severe traumatic brain injury in patients: a retrospective study Melisa Cetin, Ping Yip, Wing Sze Leung, Zhou-Hao Liu Clinical Medicine.2023; 23(6): 81. CrossRef
Pathogenic Mechanisms Underlying Cirrhotic Cardiomyopathy Hongqun Liu, Henry H. Nguyen, Ki Tae Yoon, Samuel S. Lee Frontiers in Network Physiology.2022;[Epub] CrossRef
Collagen-binding fibroblast growth factor ameliorates liver fibrosis in murine bile duct ligation injury Qiangqiang Shi, Susu Wei, Zhi Chao Li, Jing Xu, Yaxin Li, Chuanlong Guo, Xianggen Wu, Chunying Shi, Guohu Di Journal of Biomaterials Applications.2022; 37(5): 918. CrossRef
Background/Aims Left ventricular diastolic dysfunction (LVDD) is an early manifestation of cardiac dysfunction in patients with liver cirrhosis (LC). However, the effect of LVDD on survival has not been clarified, especially in decompensated LC.
Methods We prospectively enrolled 70 patients with decompensated LC, including ascites or variceal bleeding, at Daejeon St. Mary’s Hospital from April 2013 to April 2015. The cardiac function of these patients was evaluated using 2D echocardiography with tissue Doppler imaging. The diagnosis of LVDD was based on the American Society of Echocardiography guidelines. The primary endpoint was overall survival.
Results Forty-four patients (62.9%) had LVDD. During follow-up (22.3 months), 18 patients died (16 with LVDD and 2 without LVDD). The survival rate was significantly lower in patients with LVDD than in those without LVDD (31.1 months vs. 42.6 months, P=0.01). In a multivariate analysis, the Child-Pugh score and LVDD were independent predictors of survival. Moreover, patients with a ratio of early filling velocity to early diastolic mitral annular velocity (E/e’) ≥ 10 (LVDD grade 2) had lower survival than patients with E/e’ ratio < 10.
Conclusions The presence of LVDD is associated with poor survival in patients with decompensated LC. Therefore, it may be important to monitor and closely follow LVDD patients.
Citations
Citations to this article as recorded by
What’s new in critical illness and injury science? Cardiac dysfunction in patients with cirrhosis and its correlation with Child - Turcott - Pugh (CTP) SCORE Tarun Sharma, Christopher Caspers International Journal of Critical Illness and Injury Science.2025; 15(3): 99. CrossRef
Cirrhotic cardiomyopathy: a systematic review and meta-analysis of prevalence across various diagnostic approaches Mohammed Ewid, Suliman Alsagaby, Abdulsalam Al-Ruqi, Odi Al-Shamikh, Abdulelah Aljohani, Mariam Safwan Bourgleh, Moaz Safwana Annals of Saudi Medicine.2025; 45(4): 270. CrossRef
International Liver Transplantation Society/Liver Intensive Care Group of Europe guidelines for cardiovascular assessment before liver transplantation Emmanuel Weiss, Gonzalo Crespo, Alexandra Anderson, Gianni Biancofiore, Ryan Chadha, Jacek B. Cywinski, Andrea De Gasperi, James Findlay, Marc Giménez-Milà, Constantine Karvellas, Michael Kaufman, Ashish Malik, Marina Moguilevitch, Sher-Lu Pai, Koen Reynt American Journal of Transplantation.2025;[Epub] CrossRef
Left Ventricular Diastolic Dysfunction Increases the Risk of Medium-term Mortality in Patients with Cirrhotic Ascites Sheng-Hao Li, Lu Zhang, Hong-Juan Li, Ye Li, Yan-Min Zheng, Qing-Qing Wang Romanian Journal of Internal Medicine.2025;[Epub] CrossRef
Association of NT-proBNP and sST2 with Diastolic Dysfunction in Cirrhotic Patients and Its Therapeutic Implications Roxana Mihaela Chiorescu, Alexandru Ruda, Romeo Chira, Georgiana Nagy, Adriana Bințințan, Ștefan Chiorescu, Mihaela Mocan International Journal of Molecular Sciences.2025; 27(1): 261. CrossRef
Association of echocardiography-related parameters with the prognosis of decompensated cirrhosis: a retrospective cohort study Weiwei Wang, Liyan Dong, Yue Gao, Fangbo Gao, Zhongchao Wang, Min Ding, Chunru Gu, Zhe Li, Yue Yin, Menghua Zhu, Hongxin Chen, Hongyu Li, Xingshun Qi Current Medical Research and Opinion.2024; 40(4): 613. CrossRef
An Overview of the Clinical Implications of Cirrhotic Cardiomyopathy Sarah Myers, Pakinam Mekki, Manhal Izzy Current Hepatology Reports.2024; 23(3): 389. CrossRef
Association of left ventricular diastolic dysfunction with inflammatory activity, renal dysfunction, and liver-related mortality in patients with cirrhosis and ascites Georgios Kalambokis, Maria Christaki, Ilias Tsiakas, Grigorios Despotis, Lampros Lakkas, Spiridon Tsiouris, Xanthi Xourgia, Georgios S. Markopoulos, Lefkothea Dova, Haralampos Milionis European Journal of Gastroenterology & Hepatology.2024; 36(6): 775. CrossRef
H2FPEF Scores Are Increased in Patients with NASH Cirrhosis and Are Associated with Post-liver Transplant Heart Failure David G. Koch, Don C. Rockey, Sheldon S. Litwin, Ryan J. Tedford Digestive Diseases and Sciences.2024; 69(8): 3061. CrossRef
Systolic and diastolic impairment in cirrhotic cardiomyopathy: insights from a cross-sectional study Hala Mansoor, Mahnam Khizer, Aneela Afreen, Noor Masood Sadiq, Aamir Habib, Shafqat Ali, Asim Raza, Tayyaba Hafeez Egyptian Liver Journal.2024;[Epub] CrossRef
Cirrhotic cardiomyopathy – negative prognosis factor in cirrhosis Andreea Maria Marin, Ovidiu Calapod, Gabriela Anca Angelescu, Corina Costache, Ruxandra Sfeatcu, Tribus Laura Carina Medic.ro.2023; 2(152): 19. CrossRef
Left Ventricular Diastolic Dysfunction Defined Using the 2016 ASE Criteria and Mortality after a Liver Transplant in Patients with End-Stage Liver Disease: A Systematic Review Carlos E. González-Martínez, Diego Regalado-Ceballos, Samantha Medrano-Juárez, Airam Regalado-Ceballos, Isaí E. Hernández-Padilla, José R. Azpiri-López, Homero Nañez-Terreros, Linda E. Muñoz-Espinosa Gastroenterology Insights.2023; 14(4): 653. CrossRef
Is Cirrhotic Cardiomyopathy Related to Cirrhosis Severity? Subhash Chandra Dash, Beeravelli Rajesh, Suresh Kumar Behera, Naba Kishore Sundaray, Praveen Patil Rambam Maimonides Medical Journal.2023; 14(1): e0001. CrossRef
Interplay of cardiovascular mediators, oxidative stress and inflammation in liver disease and its complications Csaba Matyas, György Haskó, Lucas Liaudet, Eszter Trojnar, Pal Pacher Nature Reviews Cardiology.2021; 18(2): 117. CrossRef
The prevalence of cirrhotic cardiomyopathy according to different diagnostic criteria Marcel Razpotnik, Simona Bota, Philipp Wimmer, Michael Hackl, Gerald Lesnik, Hannes Alber, Markus Peck‐Radosavljevic, Virginia Hernandez‐Gea Liver International.2021; 41(5): 1058. CrossRef
Direct Bilirubin Is More Valuable than Total Bilirubin for Predicting Prognosis in Patients with Liver Cirrhosis Han Ah Lee, Joon Young Jung, Young-Sun Lee, Young Kul Jung, Ji Hoon Kim, Hyonggin An, Hyung Joon Yim, Yoon Tae Jeen, Jong Eun Yeon, Kwan Soo Byun, Soon Ho Um, Yeon Seok Seo Gut and Liver.2021; 15(4): 599. CrossRef
Current Concepts of Cirrhotic Cardiomyopathy Manhal J. Izzy, Lisa B. VanWagner Clinics in Liver Disease.2021; 25(2): 471. CrossRef
Diastolic Dysfunction Is a Predictor of Poor Survival in Patients with Decompensated Cirrhosis Manas Kumar Behera, Surendra Nath Swain, Manoj Kumar Sahu, Gaurav Kumar Behera, Debakanta Mishra, Jimmy Narayan, Ayaskant Singh, Shobhit Agarwal, Pradeep Kumar Mallick, Fredric D. Gordon International Journal of Hepatology.2021; 2021: 1. CrossRef
Factors Predicting Cardiac Dysfunction in Patients with Liver Cirrhosis Manas Kumar Behera, Jimmy Narayan, Manoj Kumar Sahu, Suresh Kumar Behera, Ayaskanta Singh, Debakanta Mishra, Shobhit Agarwal, Kanishka Uthansingh Middle East Journal of Digestive Diseases.2021; 13(3): 216. CrossRef
Impact of the 2016 ASE/EACVI Guidelines on diastolic function reporting in routine clinical practice Prabhakaran Gopalakrishnan, Robert Biederman Echocardiography.2020; 37(4): 546. CrossRef
Early echocardiographic signs of diastolic dysfunction predict acute kidney injury in cirrhotic patients Pei-Shan Wu, Ying-Wen Wang, Cheng-Chun Tai, Yun-Cheng Hsieh, Pei-Chang Lee, Chin-Chou Huang, Yi-Hsiang Huang, Ming-Chih Hou, Han-Chieh Lin, Kuei-Chuan Lee Journal of the Chinese Medical Association.2020; 83(11): 984. CrossRef
An update on cirrhotic cardiomyopathy Søren Møller, Karen V. Danielsen, Signe Wiese, Jens D. Hove, Flemming Bendtsen Expert Review of Gastroenterology & Hepatology.2019; 13(5): 497. CrossRef
Liver cirrhosis and left ventricle diastolic dysfunction: Systematic review Ieva Stundiene, Julija Sarnelyte, Ausma Norkute, Sigita Aidietiene, Valentina Liakina, Laura Masalaite, Jonas Valantinas World Journal of Gastroenterology.2019; 25(32): 4779. CrossRef
Syndecan-1: A Review on Its Role in Heart Failure and Chronic Liver Disease Patients’ Assessment Radu-Stefan Miftode, Ionela-Lăcrămioara Şerban, Amalia-Stefana Timpau, Ionela-Larisa Miftode, Adriana Ion, Ana-Maria Buburuz, Alexandru-Dan Costache, Irina-Iuliana Costache Cardiology Research and Practice.2019; 2019: 1. CrossRef
Cirrhotic cardiomyopathy: An independent prognostic factor for cirrhotic patients Yun Bin Lee, Jeong-Hoon Lee Clinical and Molecular Hepatology.2018; 24(4): 372. CrossRef
Most patients with liver cirrhosis have hyperdynamic circulatory alterations with increased cardiac output,
and decreased systemic vascular resistance and arterial pressure. But, in spite of the increased resting cardiac
output, ventricular contractile response to stressful stimuli is attenuated in cirrhotic patients which is termed
as cirrhotic cardiomyopathy. The prevalence of cirrhotic cardiomyopathy remains unknown at present. Clinical
features include structural, histological, electrophysiological, systolic and diastolic dysfunction. Multiple factors
are considered as responsible, including impaired β-adrenergic receptor signal transduction, abnormal
membrane biophysical characteristics, and increased activity of cardiodepressant systems mediated by cGMP.
Generally, cirrhotic cardiomyopathy with overt severe heart failure is rare. However, major stresses on the
cardiovascular system such as liver transplantation, infections and insertion of transjugular intrahepatic
portosystemic shunts (TIPS) can unmask the presence of cirrhotic cardiomyopathy and thereby convert latent
to overt heart failure. Cirrhotic cardiomyopathy may also contribute to the pathogenesis of hepatorenal
syndrome and circulatory failure in liver cirrhosis. Because of the marked paucity of treatment studies, current
recommendations for management are empirical, nonspecific measures. Further studies for pathogenesis and
new therapeutic strategies in this area are required. (Korean J Hepatol 2007;13:20-26)
First
Prev
