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首页> 外文期刊>Journal of Medical Biochemistry >The Relationship of Myocardial Collagen Metabolism and Reverse Remodeling after Cardiac Resynchronization Therapy
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The Relationship of Myocardial Collagen Metabolism and Reverse Remodeling after Cardiac Resynchronization Therapy

机译：心脏再同步治疗后心肌胶原代谢与逆重塑的关系

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Summary Background In the majority of patients with a wide QRS complex and heart failure resistant to optimal medical therapy, cardiac resynchronization therapy (CRT) leads to reverse ventricular remodeling and possibly to changes in cardiac collagen synthesis and degradation. We investigated the relationship of biomarkers of myocardial collagen metabolism and volumetric response to CRT. Methods We prospectively studied 46 heart failure patients (mean age 61±9 years, 87% male) who underwent CRT implantation. Plasma concentrations of amino-terminal propeptide type I (PINP), a marker of collagen synthesis, and carboxy-terminal collagen telopeptide (CITP), a marker of collagen degradation, were measured before and 6 months after CRT. Response to CRT was defined as 15% or greater reduction in left ventricular end-systolic volume at 6-month follow-up. Results Baseline PINP levels showed a negative correlation with both left ventricular end-diastolic volume (r=-0.51; p=0.032), and end-systolic diameter (r=-0.47; p=0.049). After 6 months of device implantation, 28 patients (61%) responded to CRT. No significant differences in the baseline levels of PINP and CITP between responders and nonresponders were observed (p>0.05 for both). During follow-up, responders demonstrated a significant increase in serum PINP level from 31.37±18.40 to 39.2±19.19 μg/L (p=0.049), whereas in non-responders serum PINP levels did not significantly change (from 28.12±21.55 to 34.47± 18.64 μg/L; p=0.125). There were no significant changes in CITP levels in both responders and non-responders (p>0.05). Conclusions Left ventricular reverse remodeling induced by CRT is associated with an increased collagen synthesis in the first 6 months of CRT implantation.
机译：背景技术在大多数QRS复合症广泛且心力衰竭对最佳药物治疗有抵抗力的患者中，心脏再同步治疗（CRT）会导致心室重构，并可能改变心脏胶原合成和降解。我们调查了心肌胶原代谢的生物标志物和对CRT的容积反应之间的关系。方法我们对46例接受CRT植入的心力衰竭患者（平均年龄61±9岁，男性87％）进行了前瞻性研究。在CRT之前和之后6个月分别测量了I型氨基末端前肽（PINP）和胶原蛋白降解的标志物羧基末端胶原端肽（CITP）的血浆浓度。对CRT的反应被定义为在6个月的随访中左心室收缩末期容积减少15％或更多。结果基线PINP水平与左心室舒张末期容积（r = -0.51; p = 0.032）和收缩末期直径（r = -0.47; p = 0.049）均呈负相关。植入设备6个月后，有28例患者（61％）对CRT有反应。在应答者和非应答者之间，未观察到PINP和CITP基线水平的显着差异（两者均p> 0.05）。在随访期间，应答者的血清PINP水平从31.37±18.40μg/ L显着增加至39.2±19.19μg/ L（p = 0.049），而在非应答者中，血清PINP水平没有显着变化（从28.12±21.55增至34.47）。 ±18.64μg/ L; p = 0.125）。响应者和非响应者的CITP水平均无显着变化（p> 0.05）。结论CRT引起的左心室逆重塑与CRT植入后的前6个月胶原合成增加有关。

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