(Circulation. 2000;101:1527.)
© 2000 American Heart Association, Inc.
Clinical Investigation and Reports |
Relationship Between Serum Amino-Terminal Propeptide of Type III Procollagen and Changes of Left Ventricular Function After Acute Myocardial Infarction
From the Department of Internal Medicine, Division of Cardiology, Haderslev Hospital, Haderslev, and the Laboratory of Rheumatology, Hvidovre Hospital (N.B.H.), Copenhagen, Denmark.
Correspondence to Steen Hvitfeldt Poulsen, MD, PhD, Birkhøjen 53, 8382 Hinnerup, Denmark. E-mail steen.hvitfeldt{at}dadlnet.dk
Background—The amino-terminal propeptide of type III procollagen (PIIINP) is a marker of type III collagen synthesis, which has previously been shown to correlate with infarct size in nonthrombolyzed myocardial infarction (MI) and to provide prognostic information after MI.
Methods and Results—The relationship between PIIINP and changes
of left ventricular (LV) function was studied in 47
consecutive patients with first acute MI and 16 control subjects. Serum
PIIINP analysis was measured daily during hospitalization and
on days 90, 180, and 360. LV function was assessed by
echocardiography on days 1, 5, 90, and 360.
Patients with MI were stratified according to their serum PIIINP value
at day 4 (group A, 
5.0 µg/L; group B, >5.0 µg/L). On arrival, LV
function and size were comparable between groups A (n=31) and B (n=16).
LV ejection fraction, initially depressed (day 1: group A, 47±7%
versus group B, 47±8%; P=NS), increased significantly
in group A (day 360: 54±8%, P<0.001) but was
unchanged in group B (day 360: 43±8%, P=NS). LV
volumes increased significantly in group B (P<0.05) but
not in group A. Furthermore, patients in group B developed signs of
restrictive LV diastolic filling.
Multivariate regression analysis identified
PIIINP >5.0 µg/L and deceleration 140 ms as independent predictors
of cardiac death or complicating heart failure during follow-up.
Conclusions—PIIINP assessed in the subacute phase of MI relates to long-term changes of LV function and provides clinical prognostic information.
Key Words: myocardial infarction • remodeling • collagen • systole • diastole
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