Macías Blanco Carlos, Fatela-Cantillo Daniel, Jiménez-Jiménez Luis, López Aguilar Raúl, Moreno-Luna Rafael, Doblas Delgado Antonio, Stiefel Pablo
Empresa Pública Hospital Alto Guadalquivir, Hospital Alta Resolución Valle del Guadiato, Peñarroya, Córdoba, España.
Med Clin (Barc). 2012 Feb 25;138(4):139-44. doi: 10.1016/j.medcli.2011.05.027. Epub 2011 Sep 21.
To evaluate the association between circulating biomarkers of collagen metabolism in serum, left ventricular mass index (LVMI) and diastolic dysfunction in patients with resistant hypertension.
Fifty-two patients with resistant hypertension and 24 healthy individuals were included. The following biomarkers of collagen metabolism were analyzed by ELISA: carboxy-terminal propeptide of procollagen type I (PICP) and transforming growth factor beta1 (TGFβ1). The biomarker C-terminal telopeptide of collagen type-I (ICTP) was assayed by electrochemiluminescence immunoassay. In the patient's group a record of 24-h blood pressure monitoring was obtained and an echocardiography was performed. Left ventricular mass was measured according to the formula of Devereux and the diastolic function according to the relation of E and A waves and mitral propagation velocity.
Hypertensive patients showed higher levels of PICP and lower levels of ICTP than controls: 83.7 (24.7) vs. 55.0 (8.7), P<.0001; and 175.0 (136.4) vs. 323.3 (121.3), P<.0001). Hypertensive patients showed a significant relationship between PICP and LVMI (r=0.631, P<.0001) and between PICP and diastolic dysfunction (r=-0.519, P<.0001). The groups with and without hypertrophy, and with or without diastolic dysfunction, differed in the mentioned peptides but not in BP values.
Our findings suggest that the analyzed markers of synthesis and degradation of collagen may be related to myocardial hypertrophy and diastolic dysfunction independent of blood pressure values.
评估难治性高血压患者血清中胶原代谢循环生物标志物、左心室质量指数（LVMI）与舒张功能障碍之间的关联。
纳入52例难治性高血压患者和24例健康个体。采用酶联免疫吸附测定法（ELISA）分析以下胶原代谢生物标志物：I型前胶原羧基末端前肽（PICP）和转化生长因子β1（TGFβ1）。采用电化学发光免疫测定法检测I型胶原C末端肽（ICTP）生物标志物。在患者组中，进行24小时血压监测记录并进行超声心动图检查。根据Devereux公式测量左心室质量，根据E波与A波的关系及二尖瓣血流速度测量舒张功能。
高血压患者的PICP水平高于对照组，ICTP水平低于对照组：83.7（24.7）对55.0（8.7），P<0.0001；以及175.0（136.4）对323.3（121.3），P<0.0001）。高血压患者的PICP与LVMI之间存在显著相关性（r = 0.631，P<0.0001），PICP与舒张功能障碍之间也存在显著相关性（r = -0.519，P<0.0001）。有或无心肌肥厚以及有或无舒张功能障碍的组在上述肽水平上存在差异，但血压值无差异。
我们的研究结果表明，所分析的胶原合成和降解标志物可能与心肌肥厚和舒张功能障碍有关，且独立于血压值。
