Abstract 1860: Plasma Connective Tissue Growth Factor is a Potential Marker of Diastolic Function and Myocardial Fibrosis in Patients with Chronic Heart Failure
Background: Abnormal regulation of extracellular matrix (ECM) is an important pathophysiological process of myocardial remodeling. The release of various cytokines in the failing myocardium has been shown to modulate myocardial fibrosis. Connective tissue growth factor (CTGF) is a profibrotic cytokine implicated in the ECM synthesis and has been recently reported as a novel mediator of myocardial fibrosis. We constructed novel enzyme-linked immunosorbent assay (ELISA) systems for the quantitative analysis of CTGF. The aim of this study was to investigate the clinical utility of plasma CTGF concentration for the diagnosis of heart failure.
Methods: We evaluated fifty-two patients with chronic heart failure (24 dilated cardiomyopathy, 11 hypertrophic cardiomyopathy, 8 ischemic cardiomyopathy,11 others). Plasma concentration of CTGF and other markers of ECM were assessed and compared with echocardiographic data.
Results: Plasma CTGF was significantly elevated in symptomatic patients in proportion to their NYHA classes and significantly correlated with plasma brain natriuretic peptide (BNP) concentration (r=0.395, P<0.01). Plasma CTGF was also correlated with plasma transforming growth factor beta (TGFβ) (p=0.493, p<0.01), matrix metalloproteinase (MMP)-2 (r=0.391, p<0.05) and tissue inhibitor of MMP-2 (r=0.359, p<0.05) concentrations. Elevation of plasma CTGF was independent from age, sex, anemia, the presence of atrial fibrillation, renal function, plasma concentrations of norepinephrine, osteopontin and angiotensin II. Interestingly, plasma CTGF was correlated with E/E’ evaluated by tissue Doppler echocardiography (r=0.592, P<0.01), but not with systolic function and left ventricular mass. On the other hand, plasma TGFβ was not correlated with the parameters of cardiac function.
Conclusions: Our study suggests that plasma CTGF concentration is a novel diagnostic marker for diastolic dysfunction and may bring the additional specific information about myocardial fibrosis and ECM homeostasis of the heart in patients with chronic heart failure.