Jirmár Radovan, Pelouch Václav, Widimský Petr, Capek Jan, Andel Michal, Průsa Richard, Pechová Martina
Cardiocenter, Department of Cardiology, 3rd Medical School, Charles University and University Hospital, Kralovske Vinohrady, Czech Repiblic.
Int Heart J. 2005 Nov;46(6):949-59. doi: 10.1536/ihj.46.949.
The aims of the present study were to analyze cardiac collagen metabolism changes in vivo during acute and nonacute phases of ST elevation myocardial infarction (STEMI) in patients who were treated with primary coronary intervention (PCI) only, and to determine the predictive significance of collagen I and III synthesis markers (PICP, PIIINP) as well as the collagen I degradation marker (ICTP) on left ventricular function and volume changes after STEMI. Serum levels of the carboxy-terminal propeptide of type I procollagen (PICP) and amino-terminal propeptide of type III procollagen (PIIINP) assessed on the 30th day and the carboxyterminal telopeptide located at the C end of collagen type I (ICTP) assessed on the 7th day after STEMI were significantly higher (P = 0.01, P = 0.019, P = 0.04, respectively) in the PCI unsuccessful group than in the PCI successful group. These findings support the theory that early and successful PCI not only limits the amount of muscle necrosis but also protects cardiac collagen from ischemia-related injury. PICP and PIIINP levels assessed on the fourth day after acute STEMI enables us to predict the development of left ventricular function (EF) and end-diastolic volume changes over the course of 6 months, irrespective of the initial EF or revascularization success.
本研究的目的是分析仅接受直接冠状动脉介入治疗（PCI）的ST段抬高型心肌梗死（STEMI）患者在急性和非急性阶段体内心脏胶原代谢的变化，并确定I型和III型胶原合成标志物（PICP、PIIINP）以及I型胶原降解标志物（ICTP）对STEMI后左心室功能和容积变化的预测意义。在STEMI后第30天评估的I型前胶原羧基末端前肽（PICP）和III型前胶原氨基末端前肽（PIIINP）的血清水平，以及在STEMI后第7天评估的位于I型胶原C末端的羧基末端端肽（ICTP），在PCI未成功组中显著高于PCI成功组（分别为P = 0.01、P = 0.019、P = 0.04）。这些发现支持了这样一种理论，即早期且成功的PCI不仅能限制心肌坏死的程度，还能保护心脏胶原免受缺血相关损伤。急性STEMI后第4天评估的PICP和PIIINP水平使我们能够预测6个月内左心室功能（EF）和舒张末期容积变化的发展，而与初始EF或血管再通成功与否无关。
