Residual stress ischaemia is associated with blood markers of myocardial structural remodelling.

Abstract:

BACKGROUND:Long-term prognosis of coronary artery disease (CAD) patients is worsened when stress ischemia persists on treatment, but the relationship with adverse cardiac remodelling had never been investigated. AIM:To analyze changes in blood markers of fibrosis in patients with chronic CAD exhibiting exercise ischaemia. METHODS:Circulating markers of collagen: (i) turnover (amino-terminal propeptide of collagen-III [PIIINP]) and (ii) degradation (matrix metalloproteinase 1 [MMP-1]), were obtained in 139 CAD patients referred for exercise 201Tl-SPECT. RESULTS:In the 57 patients who had SPECT-ischaemia, PIIINP was higher (4.3+/-2.9 microg L-1 vs. 3.1+/-1.5 microg L-1, p=0.002) and MMP-1 lower (3.8+/-2.1 microg L-1 vs. 4.7+/-2.8 microg L-1, p=0.04) than in the 82 patients without SPECT-ischaemia. PIIINP was independently related to LV volume, SPECT-ischaemia and age, whereas MMP-1 was related to current treatment with ACEI and beta-blockers (p<0.05). In the 104 patients with a normal LV ejection fraction, only PIIINP was related to SPECT-ischaemia (4.1+/-2.2 microg L-1 vs. 3.1+/-1.5 microg L-1, p=0.01). CONCLUSION:In patients with chronic CAD, exercise ischaemia is associated with increased collagen-III turnover, independently of concomitant medications and even when LV ejection fraction is normal. Long-term, this increase might relate to adverse cardiac remodelling even when cardiac function is not clearly affected at baseline.

journal_name

Eur J Heart Fail

authors

Radauceanu A,Moulin F,Djaballah W,Marie PY,Alla F,Dousset B,Virion JM,Capiaumont J,Karcher G,Aliot E,Zannad F

doi

10.1016/j.ejheart.2006.09.010

subject

Has Abstract

pub_date

2007-04-01 00:00:00

pages

370-6

issue

4

eissn

1388-9842

issn

1879-0844

pii

S1388-9842(06)00257-1

journal_volume

9

pub_type

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