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Relation of circulating markers of fibrosis and progression of left and right ventricular dysfunction in hypertensive patients with heart failure.
- Source :
-
Journal of hypertension [J Hypertens] 2009 Dec; Vol. 27 (12), pp. 2483-91. - Publication Year :
- 2009
-
Abstract
- Objective: To study the association of circulating markers of fibrosis: procollagen type III amino-terminal propeptide (PIIINP), procollagen type I carboxy-terminal propeptide (PIP) and collagen type I carboxy-terminal telopeptide (CITP): with left (LV) and right ventricular (RV) longitudinal and LV radial systolic function in patients with heart failure in the course of essential hypertension.<br />Methods: The study population consisted of 81 patients with hypertension divided into four groups according to NYHA classification and 20 healthy controls. Cardiac function was estimated by myocardial deformation indices assessed by tissue Doppler imaging. Serum PIIINP, PIP and CITP levels were quantified by radioimmunoassay.<br />Results: Progressive LV longitudinal function impairment was demonstrated in all hypertension groups as indicated by reduced peak systolic strain and strain rate and increased postsystolic strain index. The respective indicators of LV radial function were deteriorated only in NYHA classes III-IV. Concurrently, RV longitudinal function was found abnormal in NYHA classes II-IV. PIIINP concentration was higher in NYHA class III and IV, whereas CITP level was increased and PIP/CITP ratio was decreased in the NYHA IV individuals. PIIINP was an independent correlate of LV and RV longitudinal strain (R = 0.52, beta = -0.34, P < 0.001; R = 0.25, beta = -0.27, P < 0.01, respectively). PIP/CITP ratio independently determined LV radial strain in patients with LV ejection fraction less than 50% (R = 0.44, beta = 0.52, P < 0.008).<br />Conclusion: In hypertensive patients, the progressive decline in cardiac longitudinal function is related to increased collagen III synthesis, whereas the changes in collagen I turnover favoring its increased degradation might contribute to LV radial and global systolic dysfunction seen in the advanced hypertensive heart disease.
- Subjects :
- Aged
Biomarkers blood
Disease Progression
Echocardiography, Doppler methods
Female
Fibrosis
Heart Failure physiopathology
Humans
Hypertension physiopathology
Male
Middle Aged
Peptide Fragments blood
Ventricular Dysfunction, Left physiopathology
Ventricular Dysfunction, Right physiopathology
Heart Failure blood
Hypertension blood
Myocardium pathology
Procollagen blood
Ventricular Dysfunction, Left blood
Ventricular Dysfunction, Right blood
Subjects
Details
- Language :
- English
- ISSN :
- 1473-5598
- Volume :
- 27
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- Journal of hypertension
- Publication Type :
- Academic Journal
- Accession number :
- 19887955
- Full Text :
- https://doi.org/10.1097/HJH.0b013e3283316c4d