Serum procollagen type III is associated with elevated right-sided filling pressures in stable outpatients with congestive heart failure.
Elevated filling pressures are associated with heart failure deterioration, but mechanisms underlying this association remain poorly understood. We sought to investigate whether or not elevated filling pressures are associated with increased collagen turnover, evaluated by procollagen type III aminoterminal peptide (PIIINP) levels, in stable systolic heart failure. Eighty patients with heart failure with severe systolic dysfunction (ejection fraction 26 +/- 7%) were included. Patients underwent simultaneous echocardiogram with evaluation of haemodynamic parameters and blood sampling for PIIINP measurement. Mean PIIINP level was 6.11 +/- 2.62 microg l(-1). PIIINP was positively associated with estimated right atrial pressure (RAP) (r = 0.36; p = 0.001). Mean PIIINP values were 5.04 +/- 2.42 microg l(-1) in patients with estimated RAP < or = 5 mmHg, and 7.59 +/- 2.54 microg l(-1) in those with RAP > 15 mmHg (p < 0.01). In conclusion, elevated right-side filling pressures are associated with evidence of active extracellular matrix turnover, as indicated by elevated PIIINP levels, in stable systolic heart failure. Activation of extracellular matrix turnover may be implicated in the accelerated progression of heart failure syndromes seen in patients with persistent congestion.
Biolo
Andréia
A
Division of Cardiology, Hospital de Clínicas de Porto Alegre, Post-graduate Program of Cardiovascular Sciences: Cardiology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
Rohde
Luis E
LE
Goldraich
Livia A
LA
Mascarenhas
Marcello
M
Palombini
Dora V
DV
Clausell
Nadine
N
D000328:Adult; D001794:Blood Pressure; D024061:Collagen Type III / Q000097:blood*; D004562:Electrocardiography; D005109:Extracellular Matrix / Q000378:metabolism; D005260:Female; D006325:Heart Atria / Q000503:physiopathology; D006333:Heart Failure / Q000175:diagnosis / Q000503:physiopathology*; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients
D024061:Collagen Type III