Wang Thomas J, Larson Martin G, Benjamin Emelia J, Siwik Deborah A, Safa Radwan, Guo Chao-Yu, Corey Diane, Sundstrom Johan, Sawyer Douglas B, Colucci Wilson S, Vasan Ramachandran S
Framingham Heart Study, Framingham, MA, USA.
Am Heart J. 2007 Aug;154(2):291-7. doi: 10.1016/j.ahj.2007.04.006.
Left ventricular remodeling is characterized by increased collagen deposition in the extracellular matrix. Levels of plasma procollagen type III amino-terminal peptide (PIIINP), a marker of collagen turnover, are elevated in the setting of recent myocardial infarction, heart failure, and cardiomyopathy. Whether plasma PIIINP levels are a useful indicator of subclinical left ventricular abnormalities in ambulatory individuals has not been studied.
We examined 967 Framingham Heart Study participants (mean age, 56 years; 60% women) who underwent routine echocardiography and measurement of plasma PIIINP levels. All participants were free of prior myocardial infarction or heart failure. Multivariable regression analyses were performed to examine the clinical and echocardiographic correlates of PIIINP levels.
Plasma PIIINP levels increased with age and body mass index but did not significantly correlate with other cardiovascular risk factors including hypertension and diabetes. In multivariable models, there was no association between plasma PIIINP levels and left ventricular mass (P = .89), left ventricular fractional shortening (P = .15), left ventricular end-diastolic dimension (P = .51), or left atrial size (P = .68). Plasma PIIINP levels were positively correlated with tissue inhibitor of metalloproteinase-1 levels (multivariable-adjusted, P = .001).
The use of biomarkers of extracellular matrix turnover has generated recent interest, with plasma PIIINP being the most commonly studied biomarker in acute settings. However, our findings in a large, community-based cohort suggest that plasma PIIINP has limited use for the detection of structural heart disease in ambulatory individuals.
左心室重构的特征是细胞外基质中胶原沉积增加。血浆III型前胶原氨基端肽（PIIINP）水平是胶原周转的标志物，在近期心肌梗死、心力衰竭和心肌病患者中升高。血浆PIIINP水平是否是门诊患者亚临床左心室异常的有用指标尚未得到研究。
我们检查了967名弗雷明汉心脏研究参与者（平均年龄56岁；60%为女性），他们接受了常规超声心动图检查并测量了血浆PIIINP水平。所有参与者均无既往心肌梗死或心力衰竭病史。进行多变量回归分析以检查PIIINP水平的临床和超声心动图相关性。
血浆PIIINP水平随年龄和体重指数增加而升高，但与包括高血压和糖尿病在内的其他心血管危险因素无显著相关性。在多变量模型中，血浆PIIINP水平与左心室质量（P = 0.89）、左心室缩短分数（P = 0.15）、左心室舒张末期内径（P = 0.51）或左心房大小（P = 0.68）之间无关联。血浆PIIINP水平与金属蛋白酶组织抑制剂-1水平呈正相关（多变量调整后，P = 0.001）。
细胞外基质周转生物标志物的应用近来引起了关注，血浆PIIINP是急性情况下研究最广泛的生物标志物。然而，我们在一个大型社区队列中的研究结果表明，血浆PIIINP在门诊患者结构性心脏病检测中的应用有限。
