Serum procollagens, structural and functional characteristics of the heart in prediction of cardiac fibrosis after myocardial infarction

Abstract

The aim of the research is to study the dynamics of fibrosing markers of C-terminal procollagen, type I propeptide (PICP) and N-terminal propeptide type III procollagen (PIIINP) in patients with ST-segment elevation myocardial infarction (STEMI); to identify possible correlation between concentration of PICP and PIIINP with the degree of cardiac fibrosis and diastolic dysfunction (DD) in a year after MI. Material and methods. The analyzed sample included STEMI patients with preserved contractility of the left ventricular myocardium (LV). During MI 1-st day the ejection fraction due to Simpson method was ≥50%. On the 1-st and 12-th days of the disease, as well as in a year, the concentration of PICP, PIIINP in venous blood serum was determined in all the studied participants. Standard echocardiographic study was performed with an assessment of LV diastolic function and determination of the following parameters: e’ (septal part displacement), Em (lateral part displacement), and IOLP (indexed left atrium volume). In a year after STEMI, all patients underwent magnetic resonance imaging (MRI) with a contrast agent to determine the severity of fibrotic myocardial damage. Results. PICP concentration significantly decreased by annual stage relative to hospital period (p <0.001). Changes in PIIINP concentration were revealed during the 1s-t and 12-th days (p <0.001), and during the 12-th day and a year (p = 0.002). Both markers showed increased values on the 1-st day of the disease and did not decrease throughout the study. According to MRI results, it turned out that 57% (n = 49) of the observed patients had no signs of cardiac fibrosis (CF) in a year after myocardial infarction, while 10.5% of patients had a lesion ≥ 16% (n = 9). Significant correlations were obtained between CF ≥16% and PIIINP concentration on the 12-th day of MI (r = 0.72, p = 0.041), between CF ≥16% and e’ (cm / s) on the 12-th day (r = -0.66, p = 0.006). Conclusion. One can assume that it is possible to reveal developing CF risk group and, therefore, the development of DD in a year after STEMI determining the concentration of fibrosis markers at hospital stage.