title: Left ventricular reverse remodeling is not related to biopsy-detected extracellular matrix fibrosis and serum markers of fibrosis in dilated cardiomyopathy, regardless of the definition used for LVRR.
abstract: Left ventricular reverse remodeling (LVRR) is reported in dilated cardiomyopathy (DCM) patients (pts). However, numerous definitions of LVRR exist. Measurements of serum markers of fibrosis provide insight into myocardial fibrosis. The relationship between LVRR and fibrosis is poorly understood. From July 2014 until October 2015, we included 63 consecutive DCM pts (48 ± 12.1 years, EF 24.4 ± 7.4%) with completed baseline and 3-month follow-up echocardiograms. LVRR was assessed on the basis of four differing definitions. Procollagens type I and III carboxy- and amino-terminal peptides (PICP, PINP, PIIICP, and PIIINP), collagen 1, ostepontin, tumor growth factor beta-1, connective tissue growth factor, and matrix metalloproteinases (MMP-2, MMP-9), and their tissue inhibitor (TIMP-1) were measured in serum. In addition, all pts underwent right ventricular endomyocardial biopsy. Depending on the definition chosen, LVRR could be diagnosed in between 14.3 and 50.8% pts. Regardless of the LVRR definition used, the frequency of LVRR was similar in fibrosis negative and positive DCM. Minor differences of markers of fibrosis were detected between pts with and without LVRR. For every LVRR definition, adjusted and unadjusted models were constructed to evaluate the predictive value of serum fibrosis parameters. Only an increase of TIMP-1 by 1 ng/ml was found to independently increase the probability of LVRR by 0.016%. The choice of a particular definition of LVRR determines the final diagnosis, and this has a profound impact on subsequent management. LVRR is unrelated to biopsy-detected ECM fibrosis. Serum markers of fibrosis are only weakly related to LVRR, and are not of use in the prediction of LVRR.
authors.affiliation: Department of Cardiac and Vascular Diseases, John Paul II Hospital, 31-202, Krakow, Poland. pawelrub@poczta.onet.pl.
authors.forename: Paweł
authors.initials: P
authors.lastname: Rubiś
authors.affiliation: Department of Cardiac and Vascular Diseases, John Paul II Hospital, 31-202, Krakow, Poland.
authors.forename: Sylwia
authors.initials: S
authors.lastname: Wiśniowska-Śmiałek
authors.affiliation: Department of Cardiac and Vascular Diseases, John Paul II Hospital, 31-202, Krakow, Poland.
authors.forename: Barbara
authors.initials: B
authors.lastname: Biernacka-Fijałkowska
authors.affiliation: Department of Pathology, John Paul II Hospital, Pradnicka St. 80, 31-202, Krakow, Poland.
authors.forename: Lucyna
authors.initials: L
authors.lastname: Rudnicka-Sosin
authors.affiliation: Department of Molecular Biology, John Paul II Hospital, Pradnicka St. 80, Krakow, Poland.
authors.forename: Ewa
authors.initials: E
authors.lastname: Wypasek
authors.affiliation: Department of Cardiac and Vascular Diseases, John Paul II Hospital, 31-202, Krakow, Poland.
authors.forename: Artur
authors.initials: A
authors.lastname: Kozanecki
authors.affiliation: Medical Collage, Jagiellonian University, St. Ann St. 12, 31-008, Krakow, Poland.
authors.forename: Ewa
authors.initials: E
authors.lastname: Dziewięcka
authors.affiliation: Medical Collage, Jagiellonian University, St. Ann St. 12, 31-008, Krakow, Poland.
authors.forename: Patrycja
authors.initials: P
authors.lastname: Faltyn
authors.affiliation: Medical Collage, Jagiellonian University, St. Ann St. 12, 31-008, Krakow, Poland.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Karabinowska
authors.affiliation: Medical Collage, Jagiellonian University, St. Ann St. 12, 31-008, Krakow, Poland.
authors.forename: Lusine
authors.initials: L
authors.lastname: Khachatryan
authors.affiliation: Department of Cardiac and Vascular Diseases, John Paul II Hospital, 31-202, Krakow, Poland.
authors.forename: Marta
authors.initials: M
authors.lastname: Hlawaty
authors.affiliation: Department of Cardiac and Vascular Diseases, John Paul II Hospital, 31-202, Krakow, Poland.
authors.forename: Agata
authors.initials: A
authors.lastname: Leśniak-Sobelga
authors.affiliation: Department of Cardiac and Vascular Diseases, John Paul II Hospital, 31-202, Krakow, Poland.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Kostkiewicz
authors.affiliation: Department of Cardiac and Vascular Diseases, John Paul II Hospital, 31-202, Krakow, Poland.|Medical Collage, Jagiellonian University, St. Ann St. 12, 31-008, Krakow, Poland.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Płazak
authors.affiliation: Department of Cardiac and Vascular Diseases, John Paul II Hospital, 31-202, Krakow, Poland.|Medical Collage, Jagiellonian University, St. Ann St. 12, 31-008, Krakow, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Podolec
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood*; D001706:Biopsy; D002311:Cardiomyopathy, Dilated / Q000097:blood* / Q000473:pathology*; D004452:Echocardiography; D005109:Extracellular Matrix / Q000473:pathology*; D005260:Female; D005355:Fibrosis; D006801:Humans; D016015:Logistic Models; D008297:Male; D020782:Matrix Metalloproteinases / Q000097:blood; D008875:Middle Aged; D011044:Poland; D019715:Tissue Inhibitor of Metalloproteinase-1 / Q000097:blood; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling
chemical_list: D015415:Biomarkers; D019715:Tissue Inhibitor of Metalloproteinase-1; D020782:Matrix Metalloproteinases
keywords: Biopsy; Dilated cardiomyopathy; Extracellular matrix fibrosis; Reverse remodeling; Serum markers