Impact of collagen type I turnover on the long-term response to cardiac resynchronization therapy.

Abstract

AIMS:

We investigated whether collagen type I turnover influences the long-term response to cardiac resynchronization therapy (CRT).

METHODS AND RESULTS:

Serum carboxy-terminal propeptide of procollagen type I or PICP (a marker of collagen type I synthesis) and carboxy-terminal telopeptide of collagen type I or CITP (a marker of collagen type I degradation) were measured in heart failure patients at baseline and after 1 year of CRT. Patients were categorized as responders or non-responders if they increased the distance walked in 6 min by > or <10%, respectively. At baseline, the PICP:CITP ratio, an index of the degree of coupling between collagen type I synthesis and degradation was higher (P = 0.006) in responders than in non-responders. Whereas the PICP:CITP ratio decreased (P= 0.000) after treatment in responders, it remained unchanged in non-responders. Thus, at 1-year, the PICP:CITP ratio was similar in the two groups of patients. A direct correlation (r = 0.289, P = 0.037) was found between the baseline PICP:CITP ratio and the change in the distance walked in 6 min in all patients. Receiver operating characteristics curves showed that a cut-off value of 14.4 for the PICP:CITP ratio provided 70% specificity and 63% sensitivity for the predicting response to CRT with a relative risk of 2.07 (95% confidence interval, 0.98-4.39).

CONCLUSION:

Collagen type I turnover influences the long-term response to CRT. In addition, the ability of CRT to restore the balance between collagen type I synthesis and degradation is associated with a beneficial response.

• Authors: Ignacio García-Bolao, Begoña López, Alfonso Macías, Juan J Gavira, Pedro Azcárate, Javier Díez
• Journal: European heart journal (Eur Heart J) Vol. 29 Issue 7 Pg. 898-906 (Apr 2008) ISSN: 0195-668X [Print] England
• PMID: 18334474 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Collagen Type I
• Peptide Fragments
• Procollagen
• procollagen type I carboxy terminal peptide

Topics

• Aged
• Aged, 80 and over
• Cardiac Pacing, Artificial (methods)
• Collagen Type I (metabolism)
• Female
• Heart Atria (physiopathology, transplantation)
• Heart Failure (metabolism, therapy)
• Humans
• Male
• Peptide Fragments (metabolism)
• Procollagen (metabolism)
• Sensitivity and Specificity
• Treatment Outcome
• Walking