López Begoña, González Arantxa, Querejeta Ramón, Díez Javier
Division of Cardiovascular Pathophysiology, Centre for Applied Medical Research, School of Medicine, University of Navarra, Pamplona, Spain.
J Hypertens. 2005 Aug;23(8):1445-51. doi: 10.1097/01.hjh.0000173780.67308.f1.
Given the importance of fibrous tissue in leading to myocardial dysfunction and failure in hypertensive heart disease, non-invasive assessment of fibrosis could prove a clinically useful tool in hypertensive patients, particularly given the potential for cardioprotective and cardioreparative pharmacological strategies. In this regard, an emerging experimental and clinical experience holds promise for the assessment of various serum peptides arising from the metabolism of collagen types I and III in arterial hypertension. More specifically, the measurement of serum concentrations of procollagen type I carboxy-terminal propeptide (a peptide that is cleaved from procollagen type I during the synthesis of fibril-forming collagen type I) may provide indirect diagnostic information on both the extent of myocardial fibrosis and the ability of antihypertensive treatment to diminish collagen type I synthesis and reduce myocardial fibrosis in hypertensive patients. The available data set the stage for large and long-term trials to definitively validate this approach.
鉴于纤维组织在高血压性心脏病导致心肌功能障碍和衰竭过程中的重要性，纤维化的非侵入性评估可能成为高血压患者临床上有用的工具，特别是考虑到心脏保护和心脏修复药物策略的潜力。在这方面，新出现的实验和临床经验有望用于评估动脉高血压中I型和III型胶原代谢产生的各种血清肽。更具体地说，测量I型前胶原羧基末端前肽（一种在形成原纤维的I型胶原合成过程中从前胶原I型上切割下来的肽）的血清浓度，可能会提供关于心肌纤维化程度以及抗高血压治疗在高血压患者中减少I型胶原合成和降低心肌纤维化能力的间接诊断信息。现有数据为大规模长期试验奠定了基础，以最终验证这种方法。
