Ultrasonic backscatter and serum marker of cardiac fibrosis in hypertensives.
Elevations in the serum concentration of the carboxy-terminal propeptide of procollagen type I (PIP) >127 microg/L have been found to predict severe myocardial fibrosis in hypertensive patients. This study was designed to assess whether ultrasonic reflectivity, evaluated by a real-time integrated backscatter analysis, was related to the severity of myocardial fibrosis as estimated by serum PIP. Thirty-four subjects were included in the study. Serum PIP was measured by specific radio immunoanalysis. Backscatter cyclic variation and maximal intensity were measured in 6 regions throughout the left ventricle. The subjects were divided into 3 groups: 14 normotensives with PIP <127 microg/L (group 1), 12 hypertensives with PIP <127 microg/L (group 2), and 8 hypertensives with PIP >127 microg/L (group 3). The highest cyclic variation was found in group 1 and the lowest in group 3 (5.78+/-0.25 versus 4.70+/-0.33 dB, P<0.05), with intermediate values in group 2 (5.10+/-0.27 dB). No differences in maximal intensity were found among the 3 groups of subjects. Using receiver operating characteristics curves, we observed that a cutoff of 2.90 dB for cyclic variation measured in the apex provided 75% sensitivity and 63% specificity for predicting PIP >127 microg/L in hypertensives, with a relative risk of 2.50 (95% CI, 0.72 to 34.70). These results show an association between diminished cyclic variation of backscatter and increased serum concentration of PIP in hypertension. Thus, the combination of these 2 parameters may be useful for the diagnosis of severe myocardial fibrosis associated with hypertension.
Maceira
Alicia M
AM
Department of Cardiology and Cardiovascular Surgery, University Clinic of Navarra, University of Navarra, Pamplona, Spain.
Barba
Joaquín
J
Varo
Nerea
N
Beloqui
Oscar
O
Díez
Javier
J
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D009202:Cardiomyopathies / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D004452:Echocardiography / Q000379:methods*; D005260:Female; D005355:Fibrosis; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000097:blood*; D011347:Procollagen / Q000097:blood*; D012372:ROC Curve; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging
D015415:Biomarkers; D010446:Peptide Fragments; D011347:Procollagen; C042813:procollagen type I carboxy terminal peptide