Keywords
fibrosis
diastole
ventricular remodeling
How to Cite
Abstract
Background. Arterial hypertension is accompanied by myocardial remodeling, in particular changes in the extracellular matrix and collagen turnover. The N-terminal Propeptide of Procollagen type III (PIIINP) is a circulating marker of collagen type III turnover, but it is not a cardiac-specific or direct method for determining myocardial fibrosis.
Aim. To determine the serum level of the N-terminal propeptide of procollagen type III in patients with arterial hypertension and to analyze its associations with echocardiographic parameters.
Materials and Methods. A total of 32 patients aged 18–65 years with arterial hypertension stage I–II and 22 individuals of the control group were examined. PIIINP was determined by enzyme-linked immunosorbent assay using the E-EL-H0183 Human PIIINP kit (Elabscience Biotechnology Co., Ltd, China); the detection range is 23.44–1,500 pg/mL, sensitivity – 14.06 pg/mL, intra-assay coefficient of variation – 4.15–6.27%, inter-assay – 7.01–8.80%. Doppler echocardiography was performed on the UltimaPRO30 system (RADMIR, Kharkiv, Ukraine). Correlations were assessed using Spearman's coefficient. Excel 2019 (Microsoft, USA) and SPSS Statistics 26.0 (IBM, USA) were used; results were considered statistically significant at p<0.05. The study was conducted as a private initiative of the author without grant support or state registration of the research topic.
Research Ethics. The study was conducted in accordance with the World Medical Association Declaration of Helsinki (1964–2024); all included patients provided informed consent to participate in the study, and data confidentiality was ensured.
Results. In patients with arterial hypertension, the serum PIIINP level was higher than in the control group: [1.22±0.21] µg/L vs [0.23±0.14] µg/L (p<0.001). No statistically significant correlations with structural and geometric echocardiographic parameters were found. Moderate direct correlations were established with the peak early diastolic transmitral flow velocity E (ρ=0.387; p=0.029) and the E/Ea ratio (ρ=0.367; p=0.039).
Conclusions. In patients with arterial hypertension, a higher serum level of the N-terminal propeptide of procollagen type III and its associations with certain Doppler parameters of diastolic filling were found. These results alone do not confirm myocardial fibrosis, increased filling pressure, or future risk of heart failure; the identified correlations should be considered exploratory due to multiple comparisons and the small sample size.
Keywords: cardiology, fibrosis, diastole, ventricular remodeling.
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