Relation Between Plasma Brain Natriuretic Peptide, Serum Indexes of Collagen Type I Turnover, and Left Ventricular Remodeling After Reperfused Acute Myocardial Infarction

• Published in: The American journal of cardiology 2007-03, Vol.99 (5), p.651-656
• Main Authors: Cerisano, Giampaolo, MD, Pucci, Paolo Domenico, MD, Sulla, Antonio, MD, Tommasi, Mariasilvia, MD, Raspanti, Silvia, BSc, Santoro, Giovanni Maria, MD, Antoniucci, David, MD
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Angioplasty; Angioplasty, Balloon, Coronary; Biological and medical sciences; Brain; Cardiology; Cardiology. Vascular system; Cardiovascular; Collagen Type I; Coronary heart disease; Female; Follow-Up Studies; Heart; Heart attacks; Humans; Male; Medical sciences; Middle Aged; Myocardial Infarction - blood; Myocardial Infarction - diagnostic imaging; Myocardial Infarction - therapy; Myocarditis. Cardiomyopathies; Natriuretic Peptide, Brain - blood; Peptide Fragments - blood; Peptides; Plasma; Procollagen - blood; Prospective Studies; Protein synthesis; Studies; Time Factors; Ultrasonography; Ventricular Remodeling - physiology
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2006.09.114

The aim of the study is to investigate the relation between plasma brain natriuretic peptide (BNP), collagen type I turnover, and left ventricular (LV) remodeling after primary angioplasty. Echo-Doppler, BNP, carboxy-terminal telopeptide of procollagen type I (ICTP), C-terminal propeptide of procollagen type I (PICP), and their ratio PICP/ICTP (as an index of coupling between the synthesis and degradation of collagen type I) were evaluated at days 1 and 3 and months 1 and 6 after primary angioplasty in 56 consecutive patients with a first large acute myocardial infarction (AMI). During the 6 months after AMI, a direct relation was shown between BNP and ICTP (day 1, r = 0.54, p = 0.000; day 3, r = 0.64, p = 0.000; month 1, r = 0.64, p = 0.000; month 6, r = 0.41, p = 0.005) and BNP and PICP/ICTP (day 1, r = −0.54, p = 0.003; day 3, r = −0.58, p = 0.000; month 1, r = −0.50, p = 0.000; month 6, r = −0.30, p = 0.043), but not between BNP and PICP. Using analysis of covariance, relations between BNP and ICTP and PICP/ICTP were independent from infarct size. Patients with LV remodeling had significantly higher plasma ICTP and BNP levels and lower PICP/ICTP than patients without LV remodeling. Day-1 ICTP independently predicted 6-month remodeling (exp β = 2.14, 95% confidence interval 1,120 to 3,550, p = 0.01). In conclusion, a relation exists between plasma BNP collagen type I turnover and LV remodeling after reperfused AMI.