Early changes in serum markers of cardiac extra-cellular matrix turnover in patients with uncomplicated hypertension and type II diabetes.
OBJECTIVE
Extracellular matrix (ECM) turnover is a major determinant of diastolic dysfunction and pumping capacity, thus potentially contributing to the progression of congestive heart failure (CHF). Patients with both arterial hypertension and diabetes have a high risk of heart failure. Whether these patients have changes in cardiac ECM has not been studied previously. Our objective was to compare blood markers of collagen turnover among patients with CHF, patients with hypertension and type II diabetes (HD), and healthy individuals.


RESULTS
Measurements were performed in 239 CHF patients; 64 HD patients and 92 healthy subjects. We showed by adjusted ANOVA that PIIINP levels were significantly higher in CHF and HD patients than in controls, and higher in CHF patients than in HD patients. MMP1 levels were significantly lower in CHF and HD patients than in controls. Collagen type I markers (PICP and PINP) were not influenced by CHF but were lower in HD patients as compared to controls (p<0.05 for all comparisons).


CONCLUSIONS
In heart failure, markers of cardiac collagen synthesis are increased and markers of degradation are decreased, potentially contributing to cardiac fibrosis and thus to poor outcome. Changes in collagen turnover may also occur early in the disease process in high-risk patients before heart failure is clinically detectable.
Alla
François
F
Epidemiology Department (EA 3444), University Hospital, Nancy, France.
Kearney-Schwartz
Anna
A
Radauceanu
Anca
A
Das Dores
Sylvie
S
Dousset
Brigitte
B
Zannad
Faiez
F
D000368:Aged; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D003094:Collagen / Q000032:analysis / Q000378:metabolism*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D005109:Extracellular Matrix / Q000502:physiology*; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000209:etiology*; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D008297:Male; D020781:Matrix Metalloproteinase 1 / Q000097:blood; D008875:Middle Aged; D010446:Peptide Fragments / Q000097:blood; D011347:Procollagen / Q000097:blood; D019714:Tissue Inhibitor of Metalloproteinases / Q000097:blood; D020257:Ventricular Remodeling / Q000502:physiology
D015415:Biomarkers; D010446:Peptide Fragments; D011347:Procollagen; D019714:Tissue Inhibitor of Metalloproteinases; C047202:procollagen Type I N-terminal peptide; C041876:procollagen Type III-N-terminal peptide; C042813:procollagen type I carboxy terminal peptide; D003094:Collagen; D020781:Matrix Metalloproteinase 1