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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 31, No 3, May/June 2020
AFRICA
147
Association between galectin-3 levels and isolated
coronary artery ectasia
Gonul Aciksari, Turgut Uygun, Adem Atici, Kurtulus Aciksari, Aybala Erek Toprak, Imran Onur, Yusuf
Yılmaz, Muhammed Esad Cekin, Emre Yalçınkaya, Ebuzer Aydin, Mustafa Caliskan
Abstract
Background:
Coronary artery ectasia (CAE) is a well-recog-
nised disorder characterised by abnormal dilation of the
coronary arteries. Underlying mechanisms associated with
abnormal luminal dilation in CAE remain to be elucidated.
However, histopathological features resemble those of coro-
nary atherosclerosis. Galectin-3 (Gal-3) is a valuable biomark-
er for both progression and destabilisation of atherosclerotic
lesions. To the best of our knowledge, there is no study in
the literature examining serum Gal-3 levels in patients with
isolated CAE. In the present study, therefore, we aimed to
investigate the possible relationship between serum Gal-3
levels and isolated CAE.
Methods:
Between March 2016 and March 2017 this prospec-
tive, case-controlled study included a total of 49 consecutive
isolated CAE patients (31 males, 18 females) diagnosed with
CAE by coronary angiography at the catheter laboratory
of Medeniyet University, Goztepe Training and Research
Hospital, and 43 individuals (19males, 24 females) withnormal
coronary arteries. Physical examination, medical history
history, blood biochemistry and transthoracic echocardiogra-
phy were performed in both groups. Serum concentrations of
Gal-3 were measured using blood samples.
Results:
Median Gal-3 levels were significantly higher in
isolated CAE patients than in the controls [23.2 (23.9 ±
7.1) vs 16.8 ng/ml (17.8 ± 7.3);
p
< 0.001]. According to the
Markis classification, the extent of CAE was not correlated
with Gal-3 levels (
p
= 0.41). Multivariate regression analysis
revealed that Gal-3 concentration was an independent predic-
tor of isolated CAE.
Conclusion:
Our study results suggest that Gal-3 serum
concentrations significantly increased in patients with isolated
CAE, indicating that Gal-3 may be involved in the pathogen-
esis of isolated CAE.
Keywords:
isolated coronary artery ectasia, galectin-3, athero-
sclerosis
Submitted 19/12/17, accepted 2/12/19
Published online 5/2/20
Cardiovasc J Afr
2020;
31
: 147–152
www.cvja.co.zaDOI: 10.5830/CVJA-2019-070
Coronary artery ectasia (CAE) is defined as the dilatation
of coronary arteries to a diameter of 1.5 times or greater
than that of the adjacent normal coronary artery.
1,2
Among
patients undergoing coronary angiography, 0.3 to 4.9% have
been reported to have CAE.
1,3
Isolated CAE, which is an
uncommon angiographic finding with varying presentation
patterns, is defined as pure ectasia without significant coronary
artery stenosis, accounting for 0.1 to 0.79% of all cases with
CAE.
1
More than half of the patients with CAE have coronary
atherosclerosis, although concomitant connective tissue disorder
or vasculitis may present in certain patients.
4,5
Histopathological examination of the ectatic segments reveals
extensive atherosclerotic alterations as well as disruption of the
media layer of the vessel wall. Risk factors for atherosclerosis
have also been found to be pertinent to patients with CAE.
6
These
findings have suggested that, despite having a varying aetiology,
CAE may be considered a variant of coronary atherosclerosis.
7
On the other hand, underlying mechanisms associated with
abnormal luminal dilation in CAE patients remain to be
elucidated. In addition, CAE may lead to increased cardiac
morbidity and mortality through a number of mechanisms,
including low coronary flow, coronary vasospasm and dissection
formation.
4
Galectin-3 (Gal-3) is a galactoside-binding lectin, also known
as Mac-2 antigen, which is expressed by macrophages, fibroblasts,
activated T-lymphocytes and endothelial cells.
8,9
It is involved in a
number of biological processes, including cell growth, adhesion,
Department of Cardiology, Goztepe Training and Research
Hospital, Istanbul Medeniyet University, Istanbul, Turkey
Gonul Aciksari, MD,
drgonulkutlu@hotmail.comMuhammed Esad Cekin, MD
Department of Cardiology, Sanliurfa Training and Research
Hospital, Sanliurfa, Turkey
Turgut Uygun, MD
Department of Cardiology, Mus State Hospital, Mus, Turkey
Adem Atici, MD
Department of Emergency Medicine, Faculty of Medicine,
Istanbul Medeniyet University, Istanbul, Turkey
Kurtulus Aciksari, MD
Department of Biochemistry, Goztepe Training and
Research Hospital, Istanbul Medeniyet University, Istanbul,
Turkey
Aybala Erek Toprak, MD
Emre Yalçınkaya, MD
Department of Cardiology, Istanbul Faculty of Medicine,
Istanbul University, Istanbul, Turkey
Imran Onur, MD
Department of Cardiology, Faculty of Medicine, Istanbul
Medeniyet University, Istanbul, Turkey
Yusuf Yılmaz, MD
Mustafa Caliskan, MD
Department of Cardiovascular Surgery, Faculty of
Medicine, Istanbul Medeniyet University, Istanbul, Turkey
Ebuzer Aydin, MD