Department of Cardiology, Tianjin Medical University General Hospital, Tianjin 300052, PR China.
Int J Cardiol. 2012 Apr 5;156(1):24-7. doi: 10.1016/j.ijcard.2010.10.036. Epub 2010 Nov 18.
The aim of the study was to investigate the association of plasma amino-terminal propeptide of procollagen type III (PIIINP) with subclinical left ventricular (LV) systolic dysfunction in patients with aortic stenosis (AS) and normal LV ejection fraction.
The study was performed in 57 AS patients with normal LV ejection fraction and in 30 control subjects with normal aortic valve and normal LV ejection fraction. Tissue Doppler and speckle tracking image were performed to assess LV diastolic and systolic function. Plasma PIIINP level was measured by specific radioimmunoassay.
In AS patients, LV systolic longitudinal strain was significantly reduced (-17.1 ± 2.1 vs. -18.8 ± 1.4%, P<0.001) and plasma PIIINP was increased compared with controls (2.5 ± 0.6 vs. 2.1 ± 0.4 μg/l, P<0.001). A significant correlation was found between LV systolic longitudinal strain and PIIINP (r=-0.67, P<0.001). In patients with abnormal LV diastolic function, LV systolic longitudinal strain was reduced compared with patients with normal LV diastolic function (-16.3 ± 1.5 vs. -18.8 ± 2.1%, P<0.001) and plasma PIIINP was increased (2.8 ± 0.5 vs. 2.0 ± 0.3 μg/l, P<0.001). A stepwise multivariate regression analysis revealed that LV systolic longitudinal strain and diastolic blood pressure were independent predictors of plasma PIIINP (multiple r=0.71, P<0.001).
Plasma PIIINP is associated with subclinical LV systolic dysfunction (the impaired LV systolic long axis function) in patients with AS and normal LV ejection fraction. In addition, the impaired LV systolic long axis function and increased plasma PIIINP concentration are most marked in patients with abnormal LV diastolic function.
本研究旨在探讨血浆 III 型前胶原氨基末端肽（PIIINP）与左心室收缩功能亚临床异常的关系，研究对象为左心室射血分数正常的主动脉瓣狭窄（AS）患者。
该研究共纳入 57 例左心室射血分数正常的 AS 患者和 30 例主动脉瓣正常且左心室射血分数正常的对照组。应用组织多普勒和斑点追踪成像技术评估左心室舒张和收缩功能，采用特定的放射免疫分析法测定血浆 PIIINP 水平。
与对照组相比，AS 患者的左心室收缩纵向应变明显降低（-17.1 ± 2.1% vs. -18.8 ± 1.4%，P<0.001），且血浆 PIIINP 水平升高（2.5 ± 0.6 vs. 2.1 ± 0.4 μg/l，P<0.001）。LV 收缩纵向应变与 PIIINP 呈显著负相关（r=-0.67，P<0.001）。与左心室舒张功能正常的患者相比，左心室舒张功能异常的患者左心室收缩纵向应变降低（-16.3 ± 1.5% vs. -18.8 ± 2.1%，P<0.001），且血浆 PIIINP 水平升高（2.8 ± 0.5 vs. 2.0 ± 0.3 μg/l，P<0.001）。多元逐步回归分析显示，LV 收缩纵向应变和舒张压是血浆 PIIINP 的独立预测因子（多重 r=0.71，P<0.001）。
在左心室射血分数正常的 AS 患者中，血浆 PIIINP 与亚临床左心室收缩功能障碍（左心室收缩长轴功能障碍）相关。此外，在左心室舒张功能异常的患者中，左心室收缩长轴功能障碍和血浆 PIIINP 浓度升高最为显著。
