title: The differences in the relationship between diastolic dysfunction, selected biomarkers and collagen turn-over in heart failure patients with preserved and reduced ejection fraction.
abstract: BACKGROUND
  The aim of the study was to assess the correlation of the selected biomarkers and collagen turn-over indices with advanced echocardiographic parameters among patients with preserved and reduced ejection fraction (EF).
  
  
  METHODS
  We included 62 patients with the symptomatic heart failure. The patients were divided in to two groups according to the evaluated ejection fraction (EF - Simpson method): heart failure with reduced ejection fraction (HFrEF) group - 30 patients with low EF - 35-50% (16 male, mean age 54.9 ± 12.6), heart failure with preserved ejection fraction (HFpEF) group - 32 patients with EF > 50% (16 male, mean age 62.3 ± 7.6). Clinical evaluation included 6-min walk test, biochemistry, procollagen type I N-terminal propeptide (PINP), procollagen type III N-terminal propetide (PIIINP), matrix metaloproteinase-2 (MMP2), ghrelin, and galectin-3 levels measurements. Echocardiographic examination was performed with analysis of diastolic function and global longitudinal strain (GLS).
  
  
  RESULTS
  The GLS in the HFrEF group was significantly lower than in the HFpEF group at the baseline (GLS: 9.56 vs. 16.03, p < 0.01). There was a strong negative correlation of the PIIINP and GLS in HFrEF group (r = -0.74, p = 0.005), but only a moderate negative correlation in HFpEF (r = -0.55, p = 0.02). In the HFrEF group, there was a moderate negative correlation between the baseline level of galectin-3 and GLS (r = -0.59, p = 0.03). The correlation of ghrelin and tissue inhibitor of matrix metalloproteinase-1 with EF in the HFrEF group was moderate and statistically significant (r = 0.62, p = 0.02 and r = -0.63, p = 0.02, respectively).
  
  
  CONCLUSIONS
  Procollagen type III peptide has a strong negative correlation with left ventricular GLS. Galectin-3 relationship with strain may indicate novel pathophysiological pathways and requires further investigation.
authors.affiliation: Department of Cardiology, Medical University of Lodz, Poland. bwmichalski@op.pl.
authors.forename: Błażej
authors.initials: B
authors.lastname: Michalski
authors.forename: Przemysław
authors.initials: P
authors.lastname: Trzciński
authors.forename: Karolina
authors.initials: K
authors.lastname: Kupczyńska
authors.forename: Dawid
authors.initials: D
authors.lastname: Miśkowiec
authors.forename: Łukasz
authors.initials: Ł
authors.lastname: Pęczek
authors.forename: Barbara
authors.initials: B
authors.lastname: Nawrot
authors.forename: Piotr
authors.initials: P
authors.lastname: Lipiec
authors.forename: Jarosław D
authors.initials: JD
authors.lastname: Kasprzak
mesh_terms: D054392:Adipokines / Q000097:blood; D015415:Biomarkers / Q000378:metabolism; D003094:Collagen / Q000378:metabolism*; D003971:Diastole; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000378:metabolism / Q000503:physiopathology*; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013318:Stroke Volume / Q000502:physiology*; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000378:metabolism / Q000503:physiopathology*; D016277:Ventricular Function, Left / Q000502:physiology*
chemical_list: D054392:Adipokines; D015415:Biomarkers; D003094:Collagen
keywords: adipokines; diastolic dysfunction; heart failure