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Publicaciones científicas

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

01-abr-2008 | Revista: European Heart Journal

García-Bolao I, López B, Macías A, Gavira JJ, Azcárate P, Díez J.
Department of Cardiology and Cardiovascular Surgery, University Clinic, School of Medicine, University of Navarra, Pamplona, Spain


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.

CITA DEL ARTÍCULO  Eur Heart J. 2008 Apr;29(7):898-906