Serum Carboxy-Terminal Propeptide of Procollagen Type I Is a Marker of Myocardial Fibrosis in Hypertensive Heart Disease

Abstract

Background-This study was designed to investigate whether the serum concentration of the carboxy-terminal propeptide of procollagen type I (PIP), a marker of collagen type I synthesis, is related to myocardial fibrosis in hypertensive patients. Methods and Results-The study was performed in 26 patients with essential hypertension in which ischemic cardiomyopathy was excluded after a complete medical workup. Right septal endomyocardial biopsies were performed in hypertensive patients to quantify collagen content. Collagen volume fraction (CVF) was determined on picrosirius red-stained sections with an automated image analysis system. The serum concentration of PIP was measured by specific radioimmunoassay. Compared with normotensives, both serum PIP and CVF were increased (PϽ0.001) in hypertensives. A direct correlation was found between CVF and serum PIP (rϭ0.471, PϽ0.02) in all hypertensives. Histological analysis revealed the presence of 2 subgroups of patients: 8 with severe fibrosis and 18 with nonsevere fibrosis. Serum PIP was higher (PϽ0.05) in patients with severe fibrosis than in patients with nonsevere fibrosis. Using receiver operating characteristic curves, we observed that a cutoff of 127 g/L for PIP provided 78% specificity and 75% sensitivity for predicting severe fibrosis with a relative risk of 4.80 (95% CI, 1.19 to 19.30). Conclusions-These results show a strong correlation between myocardial collagen content and the serum concentration of PIP in essential hypertension. Although preliminary, these findings suggest that the determination of PIP may be an easy and reliable method for the screening and diagnosis of severe myocardial fibrosis associated with arterial hypertension.

Losartan-Dependent Regression of Myocardial Fibrosis Is Associated With Reduction of Left Ventricular Chamber Stiffness in Hypertensive Patients

“…Coronary artery disease was excluded as previously reported. 14 Nineteen patients were treated for 1 year with losartan. No washout phase was performed so as to ensure continuous antihypertensive treatment (required by the ethics committee).…”

Time course of serum collagen types I and III metabolism products after reperfused acute myocardial infarction in patients with and without systemic hypertension

“…[11][12][13][14] This excess of myocardial collagen is primarily a result of the uncoupling between increased synthesis and unchanged or decreased degradation of collagen type I fibres. 18 However, patients with coronary heart disease have been excluded from these studies, 11-14 so it is not clear if a different pattern of interstitial remodelling may be present in the first months after AMI in patients with antecedent hypertension.…”

“…[11][12][13][14] Accordingly, we serially measured serum products collagen types I and III turnover, which constitute the bulk of cardiac ECCM, 15 and LV volumes and function in a consecutive sample of patients successfully treated with primary percuta-neous coronary intervention (PCI) for a first AMI with LV systolic dysfunction. The purpose of this study was to evaluate if a different pattern of ECCM and LV remodelling is present in patients with antecedent hypertension compared with those without hypertension.…”

Liver transduction with a simian virus 40 vector encoding insulin-like growth factor I reduces hepatic damage and the development of liver cirrhosis

“…Liver collagen content was assessed by Sirius red staining and scored by imaging analysis (AnalySIS 3.1, Soft Imaging System, Mü nster, Germany). 41 …”