title: Early changes in serum markers of cardiac extra-cellular matrix turnover in patients with uncomplicated hypertension and type II diabetes.
abstract: 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.
authors.affiliation: Epidemiology Department (EA 3444), University Hospital, Nancy, France.
authors.forename: François
authors.initials: F
authors.lastname: Alla
authors.forename: Anna
authors.initials: A
authors.lastname: Kearney-Schwartz
authors.forename: Anca
authors.initials: A
authors.lastname: Radauceanu
authors.forename: Sylvie
authors.initials: S
authors.lastname: Das Dores
authors.forename: Brigitte
authors.initials: B
authors.lastname: Dousset
authors.forename: Faiez
authors.initials: F
authors.lastname: Zannad
mesh_terms: 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
chemical_list: 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