title: Dilated cardiomyopathy is associated with significant changes in collagen type I/III ratio.
abstract: BACKGROUND
  It is controversial whether myocardial fibrosis in end-stage dilated cardiomyopathy (DCM) is associated with altered collagen type I/type III (Col I/Col III) ratio.
  
  
  RESULTS
  Patients with DCM (ejection fraction [EF] <50%, n=12) and with mild global left ventricular dysfunction (EF >50%, n=18) were examined. Col I, Col III, and transforming growth factors-beta1 (TGF-beta1) and -beta2 (TGF-beta2) gene expression in endomyocardial biopsies was evaluated by quantitative competitive reverse transcriptase-polymerase chain reaction (qRT-PCR). Collagen content was quantified after picrosirius red and immunohistological staining and by hydroxyproline assay. In patients with EF <50%, there was a pronounced 2- to 6-fold increase of myocardial Col I mRNA abundance (P<0.01), with a corresponding 1.6-fold increase at the protein level versus that found in patients with EF >50%. The Col III mRNA abundance showed a 2.0-fold increase (P<0.04). There was a relevant shift in the Col I/Col III mRNA ratio for DCM patients (Col I/Col III, 8.2) compared with patients with an EF >50% (Col I/Col III, 6. 4). In addition, total collagen content was increased in patients with EF <50% (n=3) (4.3+/-0.1%) compared with patients with EF >50% (n=8) (2.7+/-0.9%) (P<0.004). The biochemically determined ratio of hydroxyproline/total protein (n=12) was correlated to the Col I mRNA abundance (P<0.05, r=0.77). TGF-beta1 and TGF-beta2 showed elevated myocardial mRNA abundances (1- to 7-fold and 4- to 5-fold, respectively) in DCM patients.
  
  
  CONCLUSIONS
  Differential increase of Col I and Col III leads to an increased Col I/Col III ratio in DCM myocardium. Because Col I provides substantial tensile strength and stiffness, this may contribute to systolic and in particular diastolic dysfunction in DCM.
authors.affiliation: Medical Clinic II, University Hospital Benjamin Franklin, Freie Universität Berlin, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Pauschinger
authors.forename: D
authors.initials: D
authors.lastname: Knopf
authors.forename: S
authors.initials: S
authors.lastname: Petschauer
authors.forename: A
authors.initials: A
authors.lastname: Doerner
authors.forename: W
authors.initials: W
authors.lastname: Poller
authors.forename: P L
authors.initials: PL
authors.lastname: Schwimmbeck
authors.forename: U
authors.initials: U
authors.lastname: Kühl
authors.forename: H P
authors.initials: HP
authors.lastname: Schultheiss
mesh_terms: D001706:Biopsy; D002311:Cardiomyopathy, Dilated / Q000378:metabolism*; D003094:Collagen / Q000235:genetics*; D005260:Female; D005786:Gene Expression Regulation / Q000502:physiology; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D006909:Hydroxyproline / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009205:Myocarditis / Q000378:metabolism; D012333:RNA, Messenger / Q000378:metabolism*; D020133:Reverse Transcriptase Polymerase Chain Reaction; D016212:Transforming Growth Factor beta / Q000378:metabolism
chemical_list: D012333:RNA, Messenger; D016212:Transforming Growth Factor beta; D003094:Collagen; D006909:Hydroxyproline