Biochemical assessment of myocardial fibrosis in hypertensive heart disease.
Fibrous tissue accumulation is an integral feature of the adverse structural remodeling of cardiac tissue seen with hypertensive heart disease. Given the importance of fibrous tissue in leading to myocardial dysfunction and failure, noninvasive monitoring of myocardial fibrosis by use of serological markers of collagen turnover could prove a clinically useful tool, particularly given the potential for cardioprotective and cardioreparative pharmacological strategies. An emerging experimental and clinical experience holds promise for the use of radioimmunoassays of various serological markers of fibrillar collagen type I and type III turnover in arterial hypertension. More specifically, the measurement of serum concentrations of procollagen type I C-terminal propeptide (a peptide that is cleaved from procollagen type I during the synthesis of fibril-forming collagen type I) may provide indirect diagnostic information on both the extent of myocardial fibrosis and the ability of antihypertensive treatment to diminish collagen type I synthesis and reduce myocardial fibrosis. This approach represents an exciting and innovative strategy, and available data set the stage for larger trials, in which noninvasive measures of fibrosis in hypertensive heart disease could prove useful.
López
B
B
Division of Cardiovascular Pathophysiology, School of Medicine, Department of Clinical Chemistry, University Clinic, University Clinic, University of Navarra, Pamplona, Spain.
González
A
A
Varo
N
N
Laviades
C
C
Querejeta
R
R
Díez
J
J
D000818:Animals; D015415:Biomarkers / Q000097:blood; D003094:Collagen / Q000097:blood; D024042:Collagen Type I / Q000378:metabolism; D004719:Endomyocardial Fibrosis / Q000097:blood* / Q000473:pathology; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000473:pathology; D008954:Models, Biological; D010446:Peptide Fragments / Q000097:blood; D010455:Peptides / Q000097:blood; D011347:Procollagen / Q000097:blood; D051381:Rats; D012084:Renin-Angiotensin System
D015415:Biomarkers; D024042:Collagen Type I; D010446:Peptide Fragments; D010455:Peptides; D011347:Procollagen; C052929:collagen type I trimeric cross-linked peptide; C042813:procollagen type I carboxy terminal peptide; D003094:Collagen