고혈압성 심비대와 이완 기능의 평가에 있어서의 collagen turnover index의 임상적 유용성

Abstract

Background : Myocardial fibrosis is an important pathologic process in hypertensive heart disease and confers increased risk of hear failure. Recent studies have demeostrated the usefulness biochemeical markers of collagen tumover as markers of myocardial fibrosis. In this study, we assessed the correlation of fibrillar collagen turnover index (the ratio of synthesis to degradation) - the ration of N-termanal propeptide of type I procollagen (PINP) to C-terminal telopeptide of type I collagen (ICPT) - with left ventricular hypertrophy (LVH) and prameters of diastolic funcition in patients with hypertension. Methods : Sixty eight patients (male 44%, mean age 55±10) with non diabetic hypertension were entolled. Comprehensive transthoracic echocardiography was perfomed and serum concentration of PINP, ICTP were measured by specific radioimmunoassay. The patients were divided into weo groups (LVH and non-LVH) according to LVMI (left ventricular mass index) and LVH group was defined as male > 115 g/m2, female > 95g/m2. Results : Mitral annular early diastolic velocity (E') was lower significantly (4.8± vs 6.2±2.0 cm/sec, P< 0.001) and E/E' was higher in LVH group (10.7±9.5 vs 6.5±5.2, p=0.030), PINP or ICTP was not significantly different between the groups. PINP/ICTP was significantly correlated correlated with LVMI (r=0.26, p=0.043). Both E', and LA volume index were not correlated with PINP/ICTP (E': r=0.24, p=0.06, E/E' : r=0.21, p=0.097, LA Nol index : r=0.10, p=0.427). Conclusion: Although LVH was assiciated with higher type I collagen synthesis to degradation ratio in patients with hypertension, collagen tumover index did not show significant correlation wuth the index of diastolic dysfunction.