Circulating Biomarkers of Fibrosis Formation in Patients with Arrhythmogenic Cardiomyopathy

Figures

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  Figure 1. The effect of sex and TFC score on fibrosis biomarker levels. (A,B) PICP and the PICP/ICTP ratio was similar between females (n = 20) and males (n = 25). (C) A weak but significant correlation was found between TFC score and PICP levels (n = 45). (D) A weak correlation existed between TFC score and total collagen turnover (n = 45). Blue triangles represent preclinical variant carriers, while red dots are affected ACM patients. PICP; procollagen type I carboxy-terminal pro-peptide, ICTP; C-terminal telopeptide collagen type I, TFC; 2010 Task Force Criteria, r; Pearson correlation coefficient, ns; not significant. Unpaired Student’s t-test and Pearson’s correlation coefficient are performed. * p < 0.05.

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  Figure 2. Structural parameters in relation to fibrosis biomarkers. (A) A significant negative correlation with LVEF (n = 17) was found. (B) A moderate negative correlation was found between total collagen turnover and RVEF (n = 17). (C) A significant strong correlation with LV ESVi (n = 13) was found. (D) A weak, although not significant, positive correlation with RV ESVi existed (n = 16). (E,F) A weak non-significant correlation with LV EDVi (n = 14) existed, while no correlation was found with RV EDVi (n = 18). (G) PICP/ICTP ratios were similar in patients with RV dilatation (n = 25) and patients with normal RV dimensions (n = 7). Blue triangles represent preclinical variant carriers, while red dots are affected ACM patients. PICP; procollagen type I carboxy-terminal pro-peptide, ICTP; C-terminal telopeptide collagen type I, RV; right ventricle, LV; left ventricle, EF; ejection fraction, EDV; end-diastolic volume, ESV; end-systolic volume, BSA; body surface area, r; Pearson correlation coefficient, ns; not significant. Unpaired Student’s t-test was performed, and Pearson’s correlation coefficient was assessed. * p < 0.05.

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  Figure 3. Electrical parameters and total collagen turnover biomarkers. (A) No correlation was found between PICP/ICTP ratio and QRS duration (n = 37). (B) Similar PICP/ICTP ratios were found in patients with (n = 34) or without (n = 3) a T-wave inversion. (C,D) No difference in PICP/ICTP ratios were found in patients with a TAD (n = 7) or BBB (n = 5) when compared to patients without the presence of a TAD (n = 27) or BBB (n = 32). Blue triangles represent preclinical variant carriers, while red dots are affected ACM patients. PICP; procollagen type I carboxy-terminal pro-peptide, ICTP; C-terminal telopeptide collagen type I, TWI; T wave inversion, TAD; terminal activation duration, BBB; bundle branch block, r; Pearson correlation coefficient ns; not significant. Unpaired Student’s t-test was performed, and Pearson’s correlation coefficient was assessed.

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  Figure 4. Predicting ACM according to ROC curves of PICP and PICP/ICTP levels. Area under the curve (AUC) of PICP is 0.73 [0.57–0.89]. AUC of PICP/ICTP is 0.74 [0.58–0.90]. PICP; procollagen type I carboxy-terminal pro-peptide, ICTP; C-terminal telopeptide collagen type I.