title: Association of cardiotrophin-1 with myocardial fibrosis in hypertensive patients with heart failure.
abstract: Cardiotrophin-1 has been shown to be profibrogenic in experimental models. The aim of this study was to analyze whether cardiotrophin-1 is associated with left ventricular end-diastolic stress and myocardial fibrosis in hypertensive patients with heart failure. Endomyocardial biopsies from patients (n=31) and necropsies from 7 control subjects were studied. Myocardial cardiotrophin-1 protein and mRNA and the fraction of myocardial volume occupied by collagen were increased in patients compared with controls (P<0.001). Cardiotrophin-1 overexpression in patients was localized in cardiomyocytes. Cardiotrophin-1 protein was correlated with collagen type I and III mRNAs (r=0.653, P<0.001; r=0.541, P<0.01) and proteins (r=0.588, P<0.001; r=0.556, P<0.005) in all subjects and with left ventricular end-diastolic wall stress (r=0.450; P<0.05) in patients. Plasma cardiotrophin-1 and N-terminal pro-brain natriuretic peptide and serum biomarkers of myocardial fibrosis (carboxy-terminal propeptide of procollagen type I and amino-terminal propeptide of procollagen type III) were increased (P<0.001) in patients compared with controls. Plasma cardiotrophin-1 was correlated with N-terminal pro-brain natriuretic peptide (r=0.386; P<0.005), carboxy-terminal propeptide of procollagen type I (r=0.550; P<0.001), and amino-terminal propeptide of procollagen type III (r=0.267; P<0.05) in all subjects. In vitro, cardiotrophin-1 stimulated the differentiation of human cardiac fibroblast to myofibroblasts (P<0.05) and the expression of procollagen type I (P<0.05) and III (P<0.01) mRNAs. These findings show that an excess of cardiotrophin-1 is associated with increased collagen in the myocardium of hypertensive patients with heart failure. It is proposed that exaggerated cardiomyocyte production of cardiotrophin-1 in response to increased left ventricular end-diastolic stress may contribute to fibrosis through stimulation of fibroblasts in heart failure of hypertensive origin.
authors.affiliation: Área de Ciencias Cardiovasculares, CIMA, Avenida Pío XII 55, 31008 Pamplona, Spain. jadimar@unav.es.
authors.forename: Begoña
authors.initials: B
authors.lastname: López
authors.forename: Arantxa
authors.initials: A
authors.lastname: González
authors.forename: Ramón
authors.initials: R
authors.lastname: Querejeta
authors.forename: Mariano
authors.initials: M
authors.lastname: Larman
authors.forename: Gregorio
authors.initials: G
authors.lastname: Rábago
authors.forename: Javier
authors.initials: J
authors.lastname: Díez
mesh_terms: D009202:Cardiomyopathies / Q000209:etiology / Q000235:genetics / Q000378:metabolism*; D016207:Cytokines / Q000096:biosynthesis / Q000235:genetics*; D018450:Disease Progression; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005347:Fibroblasts / Q000378:metabolism / Q000473:pathology; D005355:Fibrosis / Q000209:etiology / Q000378:metabolism / Q000473:pathology; D005786:Gene Expression Regulation; D006333:Heart Failure / Q000150:complications / Q000235:genetics / Q000378:metabolism*; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000235:genetics / Q000378:metabolism*; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism* / Q000473:pathology; D032383:Myocytes, Cardiac / Q000378:metabolism / Q000473:pathology; D012333:RNA, Messenger / Q000235:genetics*; D060888:Real-Time Polymerase Chain Reaction
chemical_list: D016207:Cytokines; D012333:RNA, Messenger; C092073:cardiotrophin 1
keywords: cardiotrophin 1; collagen; fibrosis; heart failure