Measuring serum aminoterminal type III procollagen peptide, 7S domain of type IV collagen, and cardiac troponin T in patients with idiopathic dilated cardiomyopathy and secondary cardiomyopathy

Abstract

Objective-To identify new prognostic indicators in idiopathic dilated cardiomyopathy (DCM) and secondary cardiomyopathy. Design and patients-Serum concentrations of aminoterminal propeptides of type III procollagen and the 7S domain of type IV collagen (7S collagen)-which have recently been used as indicators of collagen matrix turnover in other diseases-and of cardiac troponin T were measured in 17 consecutive patients with DCM and in four patients with secondary cardiomyopathy (one associated with hyperthyroidism, two with chronic renal failure, one with amyloidosis), confirmed by endomyocardial biopsy. The correlation of these variables with short term prognosis was then assessed prospectively. Results-11 of the patients were positive for type III procollagen, 7S collagen, or troponin T even though their creatine kinase concentrations were within the normal range. These patients had a poor short term prognosis (p < 0.001). Conclusions-Within the DCM and secondary cardiomyopathy groups, there was a subgroup of patients with raised concentrations of serum collagen and troponin T, for whom short term prognosis was poor. Although it is unclear whether these serum peptide levels reflect ongoing myocyte degeneration and interstitial fibrosis, they may serve as useful new prognostic indicators for cardiomyopathy.

Clinical and echocardiographic correlates of plasma procollagen type III amino-terminal peptide levels in the community

“…37 Second, most prior studies of circulating PIIINP levels have been conducted in patients with severe cardiac disease, such as recent myocardial infarction 9,10,26 or congestive heart failure. 11,38,39 Interstitial collagen deposition may be substantially higher in patients with severe illness, in whom active matrix turnover may be more pronounced, than in clinically stable ambulatory individuals. Nonetheless, it is interesting to note that substantial overlap exists between the range of plasma PIIINP levels found in prior studies and in our study.…”

Persistently Increased Serum Concentrations of Cardiac Troponin T in Patients With Idiopathic Dilated Cardiomyopathy Are Predictive of Adverse Outcomes

“…Ten patients included in this study belonged to a population described in an earlier report. 5 The study procedures were in accordance with the institutional guidelines of the Hyogo Prefectural Amagasaki Hospital. The demographic and baseline clinical characteristics of the study population are presented in Table 1.…”

“…We have recently reported that patients with idiopathic and secondary DCM whose prognosis is poor have abnormally high serum concentrations of TnT in the absence of an increase in serum creatine kinase (CK) concentrations and that, in this population, TnT is a prognostic marker. 5,6 It is noteworthy that most patients with poor outcomes had persistently high TnT, even when heart failure was compensated for by conventional treatment and when they were free of dyspnea or roentgenographic and auscultatory signs of pulmonary congestion. 6 Serial measurements of serum TnT concentrations seem to be a reliable immunopathological indicator of subclinical ongoing myocyte degeneration, and we hypothesized that, in patients with cardiomyopathy, treat-ments of heart failure that ultimately improve prognosis are associated with a fall in TnT.…”

Myocardial collagen turnover in normotensive obese patients: relation to insulin resistance

“…Measurement of cardiac collagen turnover by use of serological markers is a useful tool for monitoring cardiac tissue repair and fibrosis 14 both in experimental models 15 and in clinical practice. [16][17][18][19][20] Even if LVM is in the 'normal' range, 21 it is one of the main risk factors for cardiovascular morbidity and mortality. 22 The present study was therefore undertaken: (1) to study serum markers of cardiac fibrosis in moderately obese subjects (those with a BMI of 30-39.9 kg/m 2 ) who account for 95% of the obese population.…”