title: Procollagen type III amino terminal peptide and myocardial fibrosis: A study in hypertensive patients with and without left ventricular hypertrophy.
abstract: OBJECTIVE
  An exaggerated accumulation of type I and type III fibrillar collagens occurs throughout the free wall and interventricular septum of patients with primary hypertension and left ventricular hypertrophy (LVH). In the present study the serum concentration of procollagen type III amino terminal peptide (PIIIP) was measured to determine the value of this peptide as a potential marker of ventricular fibrosis in hypertensive patients, particularly those with LVH.
  
  
  METHODS
  The study population consisted of patients with never-treated mild to moderate essential hypertension and 30 normotensive control subjects. Clinical, echocardiographic, electrocardiographic and biochemical parameters were assessed in all patients.
  
  
  RESULTS
  Heart rate, body mass index and levels of blood pressure were increased in hypertensives, particularly those with LVH, compared to normotensive controls. Posterior wall thickness, left ventricular (LV) mass and LV mass index, and serum PIIIP concentration were also increased in hypertensives, with significant differences between the two hypertensive groups. The ratio between maximal early and late transmitral flow velocity measured during diastole was lower in hypertensives, particularly those with LVH, than in normotensive controls.
  
  
  CONCLUSIONS
  The increase in PIIIP indicates that type III collagen synthesis increases in hypertensives, particularly those with LVH, implying that alterations in the heart in hypertension are the result not solely of hypertrophied LV muscle, but also of increased collagen deposition within the ventricular wall and around the coronary vessels. Thus, measurement of serum PIIIP could be a practical and useful tool in the non-invasive assessment of myocardial remodeling in hypertension.
authors.affiliation: Cadeira de Medicina I/Faculdade de Medicina de Lisboa, Serviço de Medicina I - Centro Hospitalar Lisboa Norte - Hospital S. Maria, Lisboa, Portugal. Electronic address: csmoreira2012@gmail.com.
authors.forename: Carlos
authors.initials: C
authors.lastname: dos Santos Moreira
authors.affiliation: Cadeira de Medicina II/Faculdade de Medicina de Lisboa, Serviço de Medicina II - Centro Hospitalar Lisboa Norte - Hospital S. Maria, Lisboa, Portugal.
authors.forename: Fátima
authors.initials: F
authors.lastname: Serejo
authors.affiliation: Cadeira de Medicina I/Faculdade de Medicina de Lisboa, Serviço de Medicina I - Centro Hospitalar Lisboa Norte - Hospital S. Maria, Lisboa, Portugal.
authors.forename: Paula
authors.initials: P
authors.lastname: Alcântara
authors.affiliation: Cadeira de Medicina I/Faculdade de Medicina de Lisboa, Serviço de Medicina I - Centro Hospitalar Lisboa Norte - Hospital S. Maria, Lisboa, Portugal.
authors.forename: Vítor
authors.initials: V
authors.lastname: Ramalhinho
authors.affiliation: Cadeira de Medicina I/Faculdade de Medicina de Lisboa, Serviço de Medicina I - Centro Hospitalar Lisboa Norte - Hospital S. Maria, Lisboa, Portugal.
authors.forename: J
authors.initials: J
authors.lastname: Braz Nogueira
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D005355:Fibrosis / Q000097:blood / Q000150:complications; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000150:complications; D017379:Hypertrophy, Left Ventricular / Q000097:blood* / Q000150:complications; D008297:Male; D009206:Myocardium / Q000473:pathology*; D010446:Peptide Fragments / Q000097:blood*; D011347:Procollagen / Q000097:blood*
chemical_list: D010446:Peptide Fragments; D011347:Procollagen; C041876:procollagen Type III-N-terminal peptide
keywords: Colagénio; Collagen; Hipertensão; Hipertrofia; Hypertension; Hypertrophy; Miocárdio; Myocardium; Peptides; Peptídeos