title: Circulating multimarker profile of patients with symptomatic heart failure supports enhanced fibrotic degradation and decreased angiogenesis.
abstract: BACKGROUND
  Heart failure (HF) involves myocardial fibrosis and dysregulated angiogenesis.
  
  
  OBJECTIVE
  We explored whether biomarkers of fibrosis and angiogenesis correlate with HF severity.
  
  
  METHODS
  Biomarkers of fibrosis [procollagen types I and III (PIP and P3NP), carboxyterminal-telopeptide of type I collagen (ICTP), matrix metalloproteases (MMP2 and MMP9), tissue inhibitor of MMP1 (TIMP1)]; and angiogenesis [placental growth factor (PGF), vascular endothelial growth factor (VEGF), soluble Fms-like tyrosine kinase-1 (sFlt1)] were measured in 52 HF patients and 19 controls.
  
  
  RESULTS
  P3NP, ICTP, MMP2, TIMP1, PGF, and sFlt1 levels were elevated in HF, while PIP/ICTP, PGF/sFlt1, and VEGF/sFlt1 ratios were reduced. PIP/ICTP, MMP-9/TIMP1, and VEGF/sFlt1 ratios were lowest among patients with severe HF.
  
  
  CONCLUSIONS
  Severe HF is associated with collagen breakdown and reduced angiogenesis. A multimarker approach may guide therapeutic targeting of fibrosis and angiogenesis in HF.
authors.affiliation: a Division of Cardiology , Department of Medicine, Tufts Medical Center, Molecular Cardiology Research Institute , Boston , MA , USA.
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Morine
authors.affiliation: a Division of Cardiology , Department of Medicine, Tufts Medical Center, Molecular Cardiology Research Institute , Boston , MA , USA.
authors.forename: Vikram
authors.initials: V
authors.lastname: Paruchuri
authors.affiliation: a Division of Cardiology , Department of Medicine, Tufts Medical Center, Molecular Cardiology Research Institute , Boston , MA , USA.
authors.forename: Xiaoying
authors.initials: X
authors.lastname: Qiao
authors.affiliation: a Division of Cardiology , Department of Medicine, Tufts Medical Center, Molecular Cardiology Research Institute , Boston , MA , USA.
authors.forename: Najwa
authors.initials: N
authors.lastname: Mohammad
authors.affiliation: a Division of Cardiology , Department of Medicine, Tufts Medical Center, Molecular Cardiology Research Institute , Boston , MA , USA.
authors.forename: Adam
authors.initials: A
authors.lastname: Mcgraw
authors.affiliation: a Division of Cardiology , Department of Medicine, Tufts Medical Center, Molecular Cardiology Research Institute , Boston , MA , USA.
authors.forename: Adil
authors.initials: A
authors.lastname: Yunis
authors.affiliation: a Division of Cardiology , Department of Medicine, Tufts Medical Center, Molecular Cardiology Research Institute , Boston , MA , USA.
authors.forename: Iris
authors.initials: I
authors.lastname: Jaffe
authors.affiliation: a Division of Cardiology , Department of Medicine, Tufts Medical Center, Molecular Cardiology Research Institute , Boston , MA , USA.
authors.forename: Navin K
authors.initials: NK
authors.lastname: Kapur
mesh_terms: D000368:Aged; D042501:Angiogenic Proteins / Q000097:blood; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D005355:Fibrosis; D006333:Heart Failure / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D018919:Neovascularization, Physiologic; D011446:Prospective Studies
chemical_list: D042501:Angiogenic Proteins; D015415:Biomarkers
keywords: Cardiovascular disease; growth factors/cytokines/inflammatory mediators; hematology