Diagnostic accuracy of C-terminal fragment of type I procollagen in detection of hidden heart failure in hypertensive males.
DOI:
https://doi.org/10.26641/2307-0404.2015.1.40236Keywords:
arterial hypertension, myocardial stiffness, collagen I, chronic heart failureAbstract
Purpose: to estimate diagnostic accuracy of C-terminal fragment of type I procollagen (PICP) in hypertensive males with hidden chronic heart failure (CHF). The study included 220 men with uncomplicated arterial hypertension (mean age 52 (46-58) years). The control group consisted of 40 healthy men of similar age. Ambulatory blood pressure monitoring, transthoracic echocardiography and speckle tracking echocardiography was performed to all participants. All patients underwent treadmill test with post-exercise evaluation of left ventricular (LV) filling pressure by tissue Doppler Е/е' ratio to reveal hidden CHF. The post-exercise Е/е'≥13 was considered to be pathological. PICP levels in plasma were determined by ELISA. The PICP concentration was significantly higher in men with hypertension (132,3 (81,3-216,8) ng/ml) as compared with healthy subjects (93.2 (64,7-133) ng/ml) (p=0,0068). The presence of LV hypertrophy did not affect the level of PICP (p=0,58). 16 patients presented pathological result of diastolic stress test revealing signs of hidden heart failure. PICP concentration was 2-fold higher in these individuals as compared with other patients (p=0.01). The ROC-analysis revealed, that optimal cut-off point is 170.2 ng/ml for PICP to detect hidden CHF (area under curve – 0,68±0,08; 95% confidence interval – 0,61-0,74; sensitivity – 68,7%, specificity – 69,6%). The PICP level exceeding 170,2 ng/mL testifies to hidden CHF in hypertensive males.References
Kolesnyk MY. [The expression of regulatory pro¬tein titin and collagen I in myocardium of spontaneous hypertensive rats with experimental diabetes mellitus]. Patologiya. 2013;3:31-6. Ukrainian. 2. Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380:2224–60. 3. González A, López B, Ravassa S, Beaumont J, Arias T, Hermida N et al. Biochemical markers of myocardial remodeling in hypertensive heart disease. Cardiovasc Research. 2009;81:509–18. 4. Morillas P, Quiles J, de Andrade H, Castillo J, Tarazón E, Roselló E, et al. Circulating biomarkers of collagen metabolism in arterial hypertension: relevance of target organ damage. J Hypertens. 2013;31(8):1611-17. 5. Martos R, Baugh J, Ledwidge M, O'Loughlin C, Murphy NF, Conlon C et al. Diagnosis of heart failure with preserved ejection fraction: improved accuracy with the use of markers of collagen turnover. Eur J Heart Fail. 2009;11(2):191-7. 6. Burgess MI, Jenkins C, Sharman JE, Marwick TH. Diastolic stress echocardiography: hemodynamic validation and clinical significance of estimation of ventricular filling pressure with exercise. J Am Coll Cardiol. 2006;47:1891–900. 7. Carugo S, Bolla GB, Parniani R, Caimi B, Rossetti G, Brasca F et al. Effects of valsartan treatment on indicators of cardiovascular damage in newly diagnosed hypertensive patients: A prospective, twelve-month, open-label, pilot study. Current Therapeutic Research. 2010;71(5):309-21. 8. Borlaug BA, Nishimura RA, Sorajja P, Lam CS, Redfield MM. Exercise hemodynamics enhance diagnosis of early heart failure with preserved ejection fraction. Circ Heart Fail. 2010;3(5):588-95. 9. Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hy¬pertension: analysis of worldwide data. Lancet. 2005;365(9455):217-23. 10. Querejeta R, López B, González A, Sánchez E, Larman M, Ubago JL et al. Increased collagen type I synthesis in patients with heart failure of hypertensive origin: relation to myocardial fibrosis. Circulation. 2004;110(10):1263-8. 11. Müller-Brunotte R, Kahan T, López B, Edner M, González A, Díez J et al. Myocardial fibrosis and diasto¬lic dysfunction in patients with hypertension: results from the Swedish Irbesartan Left Ventricular Hypertrophy Investigation versus Atenolol (SILVHIA). J Hypertens. 2007;25(9):1958-66. 12. Nagueh SF, Appleton CP, Gillebert TC, Marino PN, Oh JK, Smiseth OA et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography. J Am Soc Echocardiogr. 2009;22(2):107-33. 13. Querejeta R, Varo N, López B, Larman M, Ar¬tiñano E, Etayo JC et al. Serum сarboxy-terminal propep¬tide of procollagen type I is a marker of myocardial fibrosis in hypertensive heart disease. Circulation. 2000;101:1729-35.
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