Collegium Medicum of Jagiellonian University, Department of Cardiac and Vascular Diseases, John Paul II Hospital, Kraków, Poland, ul.Prądnicka 80, 31-202 Cracow, Poland.
Department of Molecular Biology, John Paul II Hospital, Krakow, Poland, ul. Prądnicka 80, 31-202 Cracow, Poland.
Cardiol J. 2020;27(6):726-734. doi: 10.5603/CJ.a2018.0143. Epub 2018 Nov 28.
Fibrosis of the extracellular matrix (ECM) in dilated cardiomyopathy (DCM) is common and compromises both systolic and diastolic function. The aim of this study was to investigate the kinetics of ECM fibrosis markers over a 12 month follow-up in patients with DCM based on the severity of diastolic dysfunction (DD).
Seventy consecutive DCM patients (48 ± 12.1 years, ejection fraction 24.4 ± 7.4%) were included in the study. The grade of DD was determined using the ASE/EACVI algorithm. Markers of ECM fibrosis were measured at baseline and at 3 and 12 month follow-ups: collagen type I and III (PICP, PINP, PIIICP, PIIINP), transforming growth factor beta-1 (TGF1-b), connective tissue growth factor (CTGF) and galectin-3 were measured.
Patients were divided into three groups according to DD severity: 30 patients with grade I, 18 with grade II and 22 with grade III of DD. Levels of PICP, PINP were increased over a 12-month period, while PIIINP decreased and PIIICP unchanged. Levels of TGF1-b decreased from the 3 to the 12-month points in grade I and II DD, and in grade III they remained unchanged. Levels of CTGF decreased over 12 months in grade III DD but were unchanged in grades I and II. Galectin-3 levels remained the same over all observation periods, irrespective of DD grade.
Regardless of the DD grade, markers of collagen type I synthesis increased, markers of collagen type III decreased. Levels of TGF and CTGF had a tendency to decrease. Galectin-3 was revealed not to be a marker discriminating the severity of DD.
扩张型心肌病（DCM）的细胞外基质（ECM）纤维化很常见，会影响收缩和舒张功能。本研究旨在根据舒张功能障碍（DD）的严重程度，研究 DCM 患者在 12 个月随访期间 ECM 纤维化标志物的动力学。
连续纳入 70 例 DCM 患者（48 ± 12.1 岁，射血分数 24.4 ± 7.4%）。采用 ASE/EACVI 算法确定 DD 程度。在基线和 3 个月及 12 个月随访时测量 ECM 纤维化标志物：Ⅰ型和Ⅲ型胶原（PICP、PINP、PIIICP、PIIINP）、转化生长因子β-1（TGF1-b）、结缔组织生长因子（CTGF）和半乳糖凝集素-3。
根据 DD 严重程度将患者分为三组：30 例 DD Ⅰ级，18 例 DD Ⅱ级，22 例 DD Ⅲ级。PICP、PINP 在 12 个月期间升高，而 PIIINP 降低，PIIICP 不变。DD Ⅰ级和Ⅱ级患者 TGF1-b 水平在 3 个月至 12 个月期间下降，而 DD Ⅲ级患者无变化。DD Ⅲ级 CTGF 水平在 12 个月内下降，但 DD Ⅰ级和Ⅱ级无变化。Galectin-3 在所有观察期内保持不变，与 DD 分级无关。
无论 DD 分级如何，Ⅰ型胶原合成标志物增加，Ⅲ型胶原标志物减少。TGF 和 CTGF 水平有下降趋势。Galectin-3 不是区分 DD 严重程度的标志物。
