| Filling pressures and collagen metabolism in hypertensive patients with heart failure and normal ejection fraction. | |
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MedLine Citation:
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PMID: 20404218 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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This study was designed to evaluate the association between circulating biomarkers of collagen metabolism and elevated left-sided filling pressures (FPs), as assessed from elevated estimated pulmonary capillary wedge pressure (ePCWP), in hypertensive patients with heart failure with normal ejection fraction. Echocardiography was performed and ePCWP was calculated from the formula ePCWP=1.90+1.24(maximum early transmitral flow velocity in diastole:tissue Doppler early mitral annulus velocity). The biomarkers of collagen synthesis (carboxy-terminal propeptide of procollagen type I) and degradation (matrix metalloproteinase [MMP] 1 and tissue inhibitor of MMP-1 [TIMP-1]) were analyzed by ELISA methods. Seventy-eight patients with normal FPs (ePCWP < or =15 mm Hg) and 78 with elevated FPs (ePCWP >15 mm Hg) were included. Compared with controls, the levels of the 3 biomarkers were increased in the 2 groups of patients. The MMP-1:TIMP-1 ratio, an index of MMP-1 activity, was increased in patients with normal FPs and unchanged in patients with elevated FPs. Patients with elevated FPs exhibited higher TIMP-1 levels and a lower MMP-1:TIMP-1 ratio than patients with normal FPs. ePCWP was independently associated with TIMP-1 (r=0.349; P<0.001) and the MMP-1:TIMP-1 ratio (r=-0.240; P<0.01) in all of the patients. Receiver operating characteristic curves showed that a cutoff value of TIMP-1 of 1557 ng/mL provided 64% sensitivity and 67% specificity for predicting elevated FPs with a relative risk of 3.71 (95% CI: 1.91 to 7.22). These findings suggest that, in hypertensive patients with heart failure with normal ejection fraction and elevated FPs, collagen synthesis predominates over degradation because of a relative excess of TIMP-1. This imbalance can facilitate myocardial fibrosis, which, in turn, may contribute to the elevation of FPs in these patients. |
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Authors:
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Arantxa Gonz?lez; Bego?a L?pez; Ram?n Querejeta; Elena Zubillaga; Tom?s Echeverr?a; Javier D?ez |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't Date: 2010-04-19 |
Journal Detail:
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Title: Hypertension Volume: 55 ISSN: 1524-4563 ISO Abbreviation: Hypertension Publication Date: 2010 Jun |
Date Detail:
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Created Date: 2010-05-20 Completed Date: 2010-06-15 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7906255 Medline TA: Hypertension Country: United States |
Other Details:
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Languages: eng Pagination: 1418-24 Citation Subset: IM |
Affiliation:
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Division of Cardiovascular Sciences, Centre for Applied Medical Research, University of Navarra, Pamplona, Spain. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Biological Markers / metabolism Blood Flow Velocity Cohort Studies Collagen / metabolism* Confidence Intervals Echocardiography Enzyme-Linked Immunosorbent Assay Female Heart Failure / metabolism, physiopathology*, ultrasonography Humans Hypertension / metabolism, physiopathology*, ultrasonography Male Matrix Metalloproteinase 1 / metabolism Probability Pulmonary Wedge Pressure* ROC Curve Severity of Illness Index Statistics, Nonparametric Stroke Volume* Tissue Inhibitor of Metalloproteinase-1 / metabolism |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; 0/Tissue Inhibitor of Metalloproteinase-1; 9007-34-5/Collagen; EC 3.4.24.7/Matrix Metalloproteinase 1 |
| Comments/Corrections | |
Comment In:
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Hypertension. 2010 Jun;55(6):1312-3
[PMID:
20404215
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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