Abstract 8777: Procollagen Levels, Cardiomyocyte Apoptosis and Diastolic Function in Asymptomatic Patients With Essential Hypertension
Introduction: Hypertension (HT) leads to left ventricular hypertrophy LVH) and dilatation. These processes are associated with loss of cardiac myocytes that results in focal sites of replacement fibrosis traditionally attributed to necrosis. However, this cardiomyocyte loss could possibly be produced through apoptosis. The aims were to analyze the relationship between aminoterminal propeptide of type III (PIIINP) and type I procollagen (PINP) and sFas, soluble TNF receptor 1 (sTNF-R1) and diastolic function in HT.
Hypothesis: We assessed the hypothesis that increased cardiac collagen turnover (PINP and PIIINP) may be associated with LVH, diastolic dysfunction and apoptosis even in asymptomatic HT.
Methods: A group of 253 Caucasian asymptomatic hypertensive patients (mean age 60±13, 139 males) from 11 hospitals. A routine physical examination, laboratory analyses, and echo-Doppler study were performed.
Results: Serum PINP and PIIINP were increased in LVH compared to non-hypertrophic patients [41 (31–52) vs. 35 (28–47), p=0.010; and 4.33 (3.71–5.29) vs. 3.98 (3.49–4.58), p=0.005, respectively]. Furthermore, sFas and sTNF-R1 levels were also elevated [1.47 (1.2–1.77) vs. 1.37 (1.1–1.59), p=0.012; and 466 (331–657) vs. 317 (260–427), p<0.0001, respectively]. Moreover, serum PIIINP concentrations were associated with log-transformed sFas (r=0.386, p<0.0001) and sTNF-R1 (r=0.298, p<0.001). PINP was also associated with these cytokines (r=0.158, p=0.011 and r=0.241, p<0.0001, respectively). Then, multivariate analyses included sFas (p<0.0001) and sTNF-R1 (p<0.0001) as independent factors of serum PIIINP. We found gender (p=0.005) and body mass index (p=0.046) as independent factors of serum PINP. Finally, marker concentrations (PINP, PIIINP, sFas and sTNF-R1) were significantly related with diastolic function parameters (p<0.0001).
Conclusions: This study showed increased circulating levels of PIIINP, PINP, and anti-apoptotic cytokines sFas and sTNF-R1 in our group of hypertrophic patients. Furthermore, sFas and sTNF-R1 are independent factors of serum type III procollagen. Diastolic parameters showed a significant association with myocardial fibrosis and anti-apoptotic cytokine levels.
- © 2010 by American Heart Association, Inc.