Abstract 2593: Serum Carboxy-Terminal Telopeptide of Type I Collagen (ICTP) Predicts Cardiac Events in Hypertensive Heart Failure Patients with Preserved Left Ventricular Systolic Function
Background: A number of epidemiological studies have documented that a high proportion of patients with heart failure have preserved left ventricular systolic function, and this condition is commonly referred to as diastolic heart failure (DHF). Although morbidity and mortality rates are high, clinical markers to predict outcomes have not yet been established in DHF. Interstitial collagen metabolism is related to left ventricular integrity and function in patients with HF. We examined whether carboxy-terminal telopeptide of type I collagen (ICTP), a marker of collagen degradations, is useful to determine the prognosis of hypertensive heart failure patients with preserved left ventricular systolic function.
Methods and Results: Serum levels of ICTP were measured at admission in 80 consecutive patients hospitalized for chronic HF and left ventricular ejection fraction > 40% (preserved left ventricular systolic function). Patients were prospectively followed during a mean follow-up period of 715 days with the end points of cardiac death and progressive heart failure requiring rehospitalization. The Cox multivariate proportional hazard analysis showed that ICTP was an independent predictor of cardiac events (hazard ratio 1.197, 95% confidence interval 1.046 - 1.369, P < 0.01). Patients were divided into 4 groups based on the ICTP levels through 1st to 4th quartile. Kaplan-Meier analysis showed that cardiac event rates increased as serum levels of ICTP rose (1st quartile 0%, 2nd 5%, 3rd 30%, and 4th 53%, P < 0.001, figure⇓).
Conclusion: Serum ICTP level was reliable for risk stratifying hypertensive heart failure patients with preserved left ventricular systolic function.