The Relation Between Serum Level of Amioterminal Propeptide of Type I Procollagen and Diastolic Dysfunction in Hypertensive Patients Without Diabetes Mellitus

In the present study, we assessed the relation between diastolic dysfunction and myocardial fibrosis in hypertensive patients without diabetes mellitus. A total of 20 medically treated ambulatory non-diabetic hypertensive patients with normal left ventricular (LV) systolic function were enrolled into this study. Myocardial fibrosis was evaluated by serum concentrations of amino-terminal propeptides of type I and III procollagen (PINP and PIIINP). All patients underwent examinations of diastolic function by echocardiography and technetium-99m (99mTc) radionuclide ventriculography. There were 8 patients with PINP ≦53 μg/l (group 1) and 12 patients with PINP >53 μg/l (group 2). Patients in group 2 had significantly lower LV peak filling rate (PFR; 3.2 ± 0.3 vs. 2.5 ± 0.2 end-diastolic volume/s) and shorter time to PFR ( 257 ± 41 vs. 174 ± 22 ms). Besides, the group 2 patients also had lower right ventricle PFR (1.9 ± 0.2 vs. 1.5 ± 0.1 end-diastolic volume/s) and shorter time to PFR ( 221 ± 29 vs. 154 ± 29 ms). Echocardiographic parameters for LV diastolic dysfunction (E/A ratio of mitral flow, deceleration time of E flow, velocities of pulmonary venous flow [retrograde A wave, systolic /diastolic velocity ratio], isovolumetric relaxation time, Tei index) were all comparable between two groups. In multiple regression analysis, LV time to peak filling rate was the only parameter that independently predicted serum PINP level (p<0.05). In conclusion, elevated serum PINP level reflected LV diastolic dysfunction in hypertensive patients without diabetes.