Plasma amino-terminal propeptide of procollagen type III is associated with subclinical left ventricular systolic dysfunction in aortic stenosis.

OBJECTIVE

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.

METHODS

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.

RESULTS

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).

CONCLUSIONS

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.