title: Clinical and echocardiographic correlates of plasma procollagen type III amino-terminal peptide levels in the community.
abstract: BACKGROUND
  Left ventricular remodeling is characterized by increased collagen deposition in the extracellular matrix. Levels of plasma procollagen type III amino-terminal peptide (PIIINP), a marker of collagen turnover, are elevated in the setting of recent myocardial infarction, heart failure, and cardiomyopathy. Whether plasma PIIINP levels are a useful indicator of subclinical left ventricular abnormalities in ambulatory individuals has not been studied.
  
  
  METHODS
  We examined 967 Framingham Heart Study participants (mean age, 56 years; 60% women) who underwent routine echocardiography and measurement of plasma PIIINP levels. All participants were free of prior myocardial infarction or heart failure. Multivariable regression analyses were performed to examine the clinical and echocardiographic correlates of PIIINP levels.
  
  
  RESULTS
  Plasma PIIINP levels increased with age and body mass index but did not significantly correlate with other cardiovascular risk factors including hypertension and diabetes. In multivariable models, there was no association between plasma PIIINP levels and left ventricular mass (P = .89), left ventricular fractional shortening (P = .15), left ventricular end-diastolic dimension (P = .51), or left atrial size (P = .68). Plasma PIIINP levels were positively correlated with tissue inhibitor of metalloproteinase-1 levels (multivariable-adjusted, P = .001).
  
  
  CONCLUSIONS
  The use of biomarkers of extracellular matrix turnover has generated recent interest, with plasma PIIINP being the most commonly studied biomarker in acute settings. However, our findings in a large, community-based cohort suggest that plasma PIIINP has limited use for the detection of structural heart disease in ambulatory individuals.
authors.affiliation: Framingham Heart Study, Framingham, MA, USA. tjwang@partners.org
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Wang
authors.forename: Martin G
authors.initials: MG
authors.lastname: Larson
authors.forename: Emelia J
authors.initials: EJ
authors.lastname: Benjamin
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Siwik
authors.forename: Radwan
authors.initials: R
authors.lastname: Safa
authors.forename: Chao-Yu
authors.initials: CY
authors.lastname: Guo
authors.forename: Diane
authors.initials: D
authors.lastname: Corey
authors.forename: Johan
authors.initials: J
authors.lastname: Sundstrom
authors.forename: Douglas B
authors.initials: DB
authors.lastname: Sawyer
authors.forename: Wilson S
authors.initials: WS
authors.lastname: Colucci
authors.forename: Ramachandran S
authors.initials: RS
authors.lastname: Vasan
mesh_terms: D015415:Biomarkers / Q000097:blood; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000097:blood*; D011347:Procollagen / Q000097:blood*; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging*; D020257:Ventricular Remodeling / Q000502:physiology*
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; D011347:Procollagen; C041876:procollagen Type III-N-terminal peptide