The relationship between aminoterminal propeptide of type III procollagen and heart rate variability parameters in heart failure patients: a potential serum marker to evaluate cardiac autonomic control and sudden cardiac death

Abstract

Background Cardiac extra-cellular matrix (ECM) fibrosis plays an important role in the pathophysiology of heart failure (HF). It may provide electrical heterogeneity and substrate for arrhythmogenicity, which may cause sudden cardiac death (SCD). Methods Twenty-one Patients with HF manifestations, and left ventricular ejection fraction (LVEF) ≤ 50% were enrolled. The median age was 62 years and median LVEF was 33 %. Time- and frequency-domain analysis of heart rate variability (HRV) on 24-hour ambulatory electrocardiography recording was assessed. Serum markers of ECM turnover including type I and III aminoterminal propeptide of procollagen (PINP and PIIINP), matrix metalloproteinase-2 and 9 (MMP-2 and MMP-9), and tissue inhibitor of metalloproteinase 1 (TIMP-1) were analyzed. Results The serum PIIINP level was significantly correlated with standard deviation of all normal RR intervals (SDNN) (r=−0.722, p=<0.001), percentage of adjacent NN interval differences >50 ms (pNN50) (r=−0.528, p=0.014), percentage of adjacent NN interval differences >20 ms (pNN20) (r=−0.545, p=0.002), very low frequency (VLF) (r=−0.490, p=0.024), low frequency (LF) (r=−0.491, p=0.024), high frequency (HF) (r=−0.513, p=0.018). PINP, MMP-2, 9, TIMP-1 were not correlated with time- and frequency-domain analysis of HRV. Conclusions PIIINP was significantly correlated with time- and frequency-domain analysis of HRV in HF patients. PIIINP is a potential serological marker to evaluate cardiac autonomic control and risk of SCD in HF patients.

Collagen peptides, interstitial remodelling and sudden cardiac death in hypertrophic cardiomyopathy

“…Also defended that collagen I synthesis prevails over degradation and correlated a passive dysfunction in HCM patients, as seen in other studies (8). These data suggest a collagen remodelling involvement in the development of HF and SCD in our patients, as described by Lin et al (4). We did not find that relation in our study population with developed HCM (72.6% of them presented fibrosis), however, we were able to find a higher ratio PICP/ICTP in patients compared to controls as Ho et al and previous studies (5,9).…”

“…In this study, PIIINP is proposed as a serum biomarker of cardiac autonomic control and risk of sudden cardiac death (SCD). Fibrosis may provide electrical heterogeneity and a substrate for arrhythmogenicity, which may cause SCD, a feared first symptom that can appear at the onset of both pathologies (HF and HCM) (4,6). They proposed that this profibrotic state precede the development of left ventricular hypertrophy or fibrosis visible on MRI (5).…”

Adrenalectomy reverses myocardial fibrosis in patients with primary aldosteronism

“…In recent years, serum markers of cardiac extracellular matrix (ECM) turnover has shown their clinical implications in several cardiovascular diseases, including hypertensive heart disease [13][14][15][16], coronary artery disease [17], and heart failure [18][19][20]. Among them, carboxy-terminal propeptide of procollagen type I (PICP) is especially useful in revealing the severity of myocardial fibrosis in hypertensive patients [13,14,16].…”

The Association of Nailfold Capillaroscopy with Systemic Matrix Metalloproteinase-9 Concentration in Normal-Tension Glaucoma

“…48,49 In contrast, MMP-2 and MMP-9 concentrations displayed no association with the occurrence of sudden cardiac death in heart-failure patients. 50 Moreover, many studies have demonstrated an association between ET-1 and glaucoma; however, no study has investigated the relationship between systemic MMP-9 and glaucoma. 22,51,52 Although both ET-1 and MMP-9 are thought to be important proteins in the surrounding tissue of the retinal vessels involved in the development of glaucoma, the relationship between systemic MMP-9 levels and autonomic dysfunction as assessed using HRV analysis is unclear.…”