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Myocardial injury and fibrogenesis: extracellular volume expansion is associated with elevated Galectin-3 levels in patients with myocarditis


Myocarditis subsumes a variety of entities, including diverse courses from complete healing to dilated cardiomyopathy with severe myocardial fibrosis. T1-mapping cardiovascular magnetic resonance (CMR) has the ability to quantify myocardial extracellular volume (ECV) as a surrogate of acute and chronic myocardial injury. Galectin-3 is an important mediator of fibrogenesis and contributes to adverse left ventricular (LV) remodeling. This study evaluated, if myocardial ECV expansion is linked to Galectin-3 levels in patients with myocarditis.


Galectin-3 blood levels were measured in 20 patients with myocarditis using a commercially available chemiluminescent microparticle immunoassay (ARCHITECT Galectin-3, Abbott Germany). T1 quantification was performed at 1.5 Tesla using the modified Look-Locker inversion-recovery (MOLLI) sequence before and 15 minutes after administration of 0.075 mmol/kg gadolinium-BOPTA. Global myocardial ECV was calculated from T1 maps generated by a dedicated plug-in written for the OsiriX software.


Median Galectin-3 level was 17.4 ng/mL (interquartile range 13.2 to 20.5 ng/mL) and median global myocardial ECV was 29 % (interquartile range 26 to 33 %) in the study population. There was a significant correlation between Galectin-3 levels and global myocardial ECV (r = 0.50; p < 0.05). In contrast, no significant correlation was found between Galectin-3 levels and LV end-diastolic volumes (r = -0.08; p = ns), LV end-systolic volumes (r = 0.06; p = ns), LV stroke volumes (r = -0.33; p = ns); LV ejection fractions (r = -0.11; p = ns), Troponin T levels (r = 0.20; p = ns) or NT-proBNP levels (r = 0.28; p = ns), respectively.


Myokardial ECV expansion, as a surrogate for myocardial injury, is associated with increased Galectin-3 levels, indicating activated fibrogenesis in patients with myocarditis. Combining Galectin-3 measurements with ECV-imaging could improve risk stratification beyond conventional imaging parameters or biomarkers in these patients.



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This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

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Radziwolek, L., Radunski, U.K., Koopmann, K. et al. Myocardial injury and fibrogenesis: extracellular volume expansion is associated with elevated Galectin-3 levels in patients with myocarditis. J Cardiovasc Magn Reson 16 (Suppl 1), P290 (2014).

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