Long-Term Effects of Delapril Hydrochloride on Procollagen Type III Amino-Terminal Peptide, Left Ventricular Mass and Left Ventricular Function in Hypertensive Patients

Matoba, Munetoshi; Asaji, Takayoshi; Matsui, Shinobu; Takekoshi, Noboru

doi:10.1253/jcj.62.900

Cited by 4 publications

(1 citation statement)

References 24 publications

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“…Several conventional drugs influence extracellular matrix metabolism, most notably thrombolytic therapy, which powerfully stimulates MMP expression and collagen degradation [109][110][111][112]. Notable are also MMP-9-lowering effect of statins [113][114][115][116] and matrix effects of thiazolidinediones [117,118], angiotensin-converting enzyme inhibitors [119][120][121][122][123][124], angiotensin II-receptor antagonists [125,126], and spironolactone [106,124]. In a small study of heart failure patients, thalidomide treatment lowered MMP-2 and also improved LV systolic function [127].…”

Section: Extracellular Matrix Peptidesmentioning

confidence: 99%

Myocardial Biomarkers for Prediction of Cardiovascular Disease

Sundström

2009

Disease Markers

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Abstract. The identification of those persons in the population who have the highest risk of future cardiovascular events is important for targeting intensive preventive efforts. This can be reliably done using a handful of long since established risk factors. The unmet need for new molecular biomarkers for prediction of cardiovascular events in the general population is therefore low. In order for a new biomarker to be used clinically for risk prediction, a statistically significant association of levels of the biomarker to adverse outcome is not enough, but the biomarker should also be demonstrated to add discriminative capacity beyond established risk factors. In contrast to the limited value of new biomarkers for risk prediction, their usefulness for unraveling the pathophysiology of cardiovascular disease is large. The myocardium is the source of a vast number of interesting biomarkers, of which a few may be useful for risk prediction in the general population. Two of these, troponin-I and the N-terminal fragment of brain natriuretic peptide, have passed tests of added discriminatory value. Numerous other biomarkers produced by cardiomyocytes or non-cardiomyocytes in the myocardium are promising, and if they are not proven useful for risk prediction, they will unquestionably enhance our understanding of cardiovascular disease.Keywords: Risk, epidemiology, population, biomarker, peptide, myocardium The need for prediction and prevention of cardiovascular eventsCardiovascular diseases kill half of the population in developed countries, and seriously disable a further large number. A high cardiovascular disease death rate in elderly persons is unavoidable, but prevention of cardiovascular deaths in younger individuals is highly prioritized, as recently outlined in the European Heart Health Charter [1].Sudden cardiac death is sometimes the first manifestation of cardiovascular disease, and traditional risk factors can be identified beforehand in a minority of these persons [2]. Further, one out of four myocardial infarctions resulting in Q-waves are asymptomatic [3], and smaller myocardial infarctions may be asymptomatic * Corresponding author: Johan Sundström, MD PhD, Department of Medical Sciences, Uppsala University Hospital, SE-751 85 Uppsala, Sweden. Tel.: +46 18 6119889 or +46 70 4225220; Fax: +46 18 509297; E-mail: johan.sundstrom@medsci.uu.se. in as much as four out of five victims [4]. Hence, the high risk strategy will not be sufficient in these cases.In order to prevent as many of premature cardiovascular deaths as possible, the Charter therefore calls for the use of both the population strategy (treating the whole population with measures such as smoking prevention or cessation, physical activity, and fruit and vegetable intake) and the high-risk strategy (identifying persons at high risk and treating risk factors aggressively). This article reviews some of the tools available for the latter strategy. The role of biomarkers in the identification of high-risk personsThe term risk factor was coined fi...

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Section: Extracellular Matrix Peptidesmentioning

confidence: 99%

Myocardial Biomarkers for Prediction of Cardiovascular Disease

Sundström

2009

Disease Markers

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Circulating biomarkers of extracellular matrix remodeling and risk of atherosclerotic events

Sundström

Vasan

2006

Current Opinion in Lipidology

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Left Ventricular Hypertrophy and Geometry in Untreated Essential Hypertension is Associated With Blood Levels of Aldosterone and Procollagen Type III Amino-Terminal Peptide

Nakahara

Takata

Hirayama

et al. 2007

Circ J

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eft ventricular hypertrophy (LVH) represents an independent risk factor for cardiovascular mortality and morbidity in patients with hypertension (HT). 1,2 In particular, concentric LVH is associated with a higher risk of cardiac arrhythmias, and even sudden death, and predicts the development of heart failure. [3][4][5] Hemodynamic load is strongly involved in the development of LVH in HT, but blood pressure and the degree of LVH do not necessarily correlate. The development of LVH is influenced by various neurohumoral factors, and the reninangiotensin-aldosterone system is strongly involved. 6 Several reports have indicated the possibility that aldosterone directly promotes myocardial hypertrophy and interstitial fibrosis. [7][8][9][10][11] A correlation between left ventricular (LV) myocardial mass and plasma aldosterone concentration (PAC) has already been reported in patients with essential HT (EHT). Some investigations have detailed LVH and the LV geometry in EHT patients already receiving treatment, 12-15 but there are no studies of patients with untreated EHT.Accordingly, the role of aldosterone in LVH and the LV geometry in patients with untreated EHT remains unclear.In the present study we focused on the serum procollagen type III amino-termnal peptide (PIIINP), which is formed during the conversion of procollagen type III to collagen type III and released into the blood, then cleared from the blood via hepatobiliary elimination. The serum concentration of PIIINP is used as a marker of collagen type III synthesis in various organs, including the liver under conditions of preserved bile excretion. [16][17][18][19] High serum levels of PIIINP have recently gained attention as reflecting ongoing fibrosis in the heart. [20][21][22][23][24] The present study had the primary objective of elucidating the relationship between aldosterone and LVH and LV geometry in patients with untreated EHT. In addition, the degree of ongoing fibrosis associated with various geometrical patterns of LVH was examined by assaying the serum PIIINP concentrations. Finally, the contribution of myocardial fibrosis to the process of LVH is discussed. Methods PatientsWe enrolled 57 consecutive patients (27 men, 30 women; mean age, 56±2 years) with untreated EHT. The criteria for HT were: systolic blood pressure ≥140 mmHg and diastolic blood pressure ≥90 mmHg. Patients with the following diseases were excluded from the study: secondary HT, coronary artery disease, valvular heart disease, atrial fib- Background The present study examined the role of aldosterone in left ventricular hypertrophy (LVH) and geometry in patients with untreated essential hypertension (EHT), and investigated the contribution of myocardial fibrosis to the process of LVH. Methods and ResultsThe relationship of the plasma aldosterone concentration (PAC) to LVH and left ventricular (LV) geometry was investigated in 57 consecutive patients with untreated EHT. PAC correlated with both LV mass index (LVMI: r=0.46, p=0.0004) and relative wall thickness (RWT: r=0.33, p=0...

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Long-Term Effects of Delapril Hydrochloride on Procollagen Type III Amino-Terminal Peptide, Left Ventricular Mass and Left Ventricular Function in Hypertensive Patients

Cited by 4 publications

References 24 publications

Myocardial Biomarkers for Prediction of Cardiovascular Disease

Myocardial Biomarkers for Prediction of Cardiovascular Disease

Circulating biomarkers of extracellular matrix remodeling and risk of atherosclerotic events

Left Ventricular Hypertrophy and Geometry in Untreated Essential Hypertension is Associated With Blood Levels of Aldosterone and Procollagen Type III Amino-Terminal Peptide

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