(Circulation. 2000;101:1729.)
© 2000 American Heart Association, Inc.
Basic Science Reports |
Serum Carboxy-Terminal Propeptide of Procollagen Type I Is a Marker of Myocardial Fibrosis in Hypertensive Heart Disease
From the Division of Cardiology, Nuestra Señora de Aránzazu Hospital, San Sebastian (R.Q., M.G.-S., J.I.E.); Divisions of Pathology (E.A.) and Hemodynamics (M.L., J.L.M.U.), Guipuzcoa Policlinics, San Sebastian; Departments of Clinical Chemistry (N.V., M.J.G., I.M.), Pathology (J.P.M.), and Cardiology (J.D.), University Clinic, and Vascular Pathophysiology Unit (B.L., J.C.E., J.D.), School of Medicine, University of Navarra, Pamplona, Spain.
Correspondence to Javier Díez, MD, PhD, Unidad de Fisiopatología Vascular, Facultad de Medicina, C/Irunlarrea s/n, 31080 Pamplona, Spain. E-mail jadimar{at}unav.es
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 (P<0.001) in hypertensives. A direct correlation was found between CVF and serum PIP (r=0.471, P<0.02) 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 (P<0.05) in patients with severe fibrosis than in patients with nonsevere fibrosis. Using receiver operating characteristic curves, we observed that a cutoff of 127 µg/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.
Key Words: collagen • hypertension • myocardium • peptides • remodeling
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