Cytokines, interstitial collagen and ventricular remodelling in dilated cardiomyopathy

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• 作者：Pekka Timonen ; Jarkko Magga ; Juha Risteli ; Kari Punnonen ; Esko Vanninen ; Anu Turpeinen ; Petri Tuomainen ; Johanna Kuusisto ; Olli Vuolteenaho ; Keijo Peuhkurinen
• 关键词：Remodelling ; Dilated cardiomyopathy ; Fibrosis ; Cytokines ; Collagen
• 刊名：International Journal of Cardiology
• 出版年：2008
• 出版时间：14 March 2008
• 年：2008
• 卷：124
• 期：3
• 页码：293-300
• 全文大小：373 K

文摘

Dilated cardiomyopathy (DCM) is associated with myocardial fibrosis, and proinflammatory cytokines may play a role in this.

Methods

N-terminal type I and III procollagen propeptides (PINP, PIIINP) and cross-linked telopeptide of type I collagen (ICTP) were measured from serum samples of 73 patients with DCM and 56 age and sex matched controls. Circulating cytokine levels were determined in DCM patients.

Results

Serum levels of PINP and PIIINP were lower in patients than in controls (p < 0.05 and p = 0.001). In patients with DCM, the levels of PIIINP and ICTP correlated significantly with each other (p < 0.01), and the proinflammatory cytokines, tumor necrosis factor alpha (TNF-α) and interleukin-6 (IL-6), correlated positively with ICTP (p < 0.001, p < 0.05), PIIINP/PINP ratio (p < 0.05, p < 0.01) and left atrial size (p < 0.01, p < 0.05). Presence of atrial fibrillation was associated with lower serum PINP level and higher PIIINP/PINP ratio (p < 0.05).

Conclusions

Our results suggest that interstitial myocardial collagen metabolism is altered in DCM patients and regulated by proinflammatory cytokines. These changes in collagen metabolism are associated with presence of atrial fibrillation, but do not reflect left ventricular remodelling. Treatment with beta-blockers and inhibitors of the renin angiotensin aldosterone system seem to effectively inhibit overall type I and III collagen syntheses.