title: Liver fibrogenesis marker, 7S domain of collagen type IV in patients with acutely decompensated heart failure: Correlates, prognostic value and time course.
abstract: BACKGROUND
  Congestion in heart failure (HF) induces multiple organ injury, which may cause remodeling of extracellular matrix. We hypothesized that liver fibrogenesis marker, 7S domain of collagen type IV (P4NP 7S) was correlated with congestion and liver injury in HF.
  
  
  RESULTS
  We measured serum P4NP 7S in two cohorts. Cohort 1 included 70 patients undergoing catheterization. P4NP 7S was correlated with pulmonary capillary wedge pressure, right ventricular and atrial pressure (r=0.50, P<0.001, r=0.42, P<0.001, r=0.39, P=0.001, respectively) but not with cardiac index (r=-0.05. P=0.7). Cohort 2 included 145 patients with acute HF, in whom we serially measured P4NP 7S at admission, discharge, early (1-month) and late (6-month) post-discharge period. γ-Glutamyltransferase and B-type natriuretic peptide were independently correlated with P4NP 7S at discharge. The cumulative 1-year incidence of death or HF hospitalization was much higher in the 3rd tertile of P4NP 7S than in the 1st and 2nd tertiles (50%, 25%, and 24%, Log-rank P=0.004). P4NP 7S enhanced risk classification when added to conventional risk factors (net reclassification improvement=0.47, P=0.02). In patients without early readmission, P4NP 7S decreased during hospitalization and remained low for up to 6months, whereas in patients with early readmission, P4NP 7S was persistently elevated during hospitalization, further increased at second admission, and remained high at 6months.
  
  
  CONCLUSIONS
  P4NP 7S was correlated with hemodynamics. The results shed new light on the pathophysiology of HF.
authors.affiliation: Department of Cardiovascular Center, Osaka Red Cross Hospital, Osaka, Japan. Electronic address: nagao@kuhp.kyoto-u.ac.jp.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Nagao
authors.affiliation: Department of Cardiovascular Center, Osaka Red Cross Hospital, Osaka, Japan.
authors.forename: Akinori
authors.initials: A
authors.lastname: Tamura
authors.affiliation: Department of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Morimoto
authors.affiliation: Department of Cardiovascular Center, Osaka Red Cross Hospital, Osaka, Japan.
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Shimamura
authors.affiliation: Department of Cardiovascular Center, Osaka Red Cross Hospital, Osaka, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yukawa
authors.affiliation: Department of Cardiovascular Center, Osaka Red Cross Hospital, Osaka, Japan.
authors.forename: Haruyasu
authors.initials: H
authors.lastname: Ito
authors.affiliation: Department of Cardiovascular Center, Osaka Red Cross Hospital, Osaka, Japan.
authors.forename: Fujio
authors.initials: F
authors.lastname: Hayashi
authors.affiliation: Department of Cardiovascular Center, Osaka Red Cross Hospital, Osaka, Japan.
authors.forename: Toshinori
authors.initials: T
authors.lastname: Makita
authors.affiliation: Department of Internal Medicine, Asahi University School of Dentistry, Mizuho, Japan.
authors.forename: Genzou
authors.initials: G
authors.lastname: Takemura
authors.affiliation: Department of Cardiology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Hyogo, Japan.
authors.forename: Yukihito
authors.initials: Y
authors.lastname: Sato
authors.affiliation: Department of Cardiovascular Center, Osaka Red Cross Hospital, Osaka, Japan.
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Inada
authors.affiliation: Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kimura
authors.affiliation: Department of Cardiovascular Center, Osaka Red Cross Hospital, Osaka, Japan.
authors.forename: Masaru
authors.initials: M
authors.lastname: Tanaka
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D024141:Collagen Type IV / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D013997:Time Factors
chemical_list: D015415:Biomarkers; D024141:Collagen Type IV
keywords: Collagen type IV; Congestion; Heart failure