Scientific publications 

Ultrasonic Backscatter and Serum Marker of Cardiac Fibrosis in Hypertensives

Maceira A.M., Barba J., Varo N., Beloqui O., Díez J.
Department of Cardiology and Cardiovascular Surgery, University Clinic of Navarra, University of Navarra, Pamplona, Spain.

Magazine: Hypertension

Date: Apr 1, 2002

Biochemistry [SP] Unidad de Chequeos [SP] Cardiology

Elevations in the serum concentration of the carboxy-terminal propeptide of procollagen type I (PIP) >127 microg/L have been found to predict severe myocardial fibrosis in hypertensive patients.

This study was designed to assess whether ultrasonic reflectivity, evaluated by a real-time integrated backscatter analysis, was related to the severity of myocardial fibrosis as estimated by serum PIP. Thirty-four subjects were included in the study. Serum PIP was measured by specific radio immunoanalysis.

Backscatter cyclic variation and maximal intensity were measured in 6 regions throughout the left ventricle. The subjects were divided into 3 groups: 14 normotensives with PIP <127 microg/L (group 1), 12 hypertensives with PIP <127 microg/L (group 2), and 8 hypertensives with PIP >127 microg/L (group 3). The highest cyclic variation was found in group 1 and the lowest in group 3 (5.78+/-0.25 versus 4.70+/-0.33 dB, P<0.05), with intermediate values in group 2 (5.10+/-0.27 dB). No differences in maximal intensity were found among the 3 groups of subjects. Using receiver operating characteristics curves, we observed that a cutoff of 2.90 dB for cyclic variation measured in the apex provided 75% sensitivity and 63% specificity for predicting PIP >127 microg/L in hypertensives, with a relative risk of 2.50 (95% CI, 0.72 to 34.70).

These results show an association between diminished cyclic variation of backscatter and increased serum concentration of PIP in hypertension. Thus, the combination of these 2 parameters may be useful for the diagnosis of severe myocardial fibrosis associated with hypertension.

CITATION  Hypertension. 2002 Apr;39(4):923-8

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