Key result
Patients with D-TGA after the atrial switch procedure had significantly higher serum levels of PIIINP compared to healthy controls (4.8 vs 3.3 μg/l, p<0.0001), indicating altered collagen turnover.
Why the study?
Do collagen turnover biomarkers correlate with systemic right ventricle remodeling and predict adverse clinical outcomes in adults with D-TGA after atrial switch procedure?
Cross-Sectional (n=85)
No
Do collagen turnover biomarkers correlate with systemic right ventricle remodeling and predict adverse clinical outcomes in adults with D-TGA after atrial switch procedure?
In adults with D-TGA after atrial switch, altered collagen turnover biomarkers correlate with systemic right ventricle remodeling and predict adverse clinical outcomes.
May support biomarker integration into D-TGA surveillance; leaves open independent prognostic value for systemic RV outcomes.
BACKGROUND: Myocardial fibrosis is a potential pathophysiological mechanism leading to systemic right ventricular (SRV) deterioration. We hypothesize that circulating levels of collagen deposition markers are elevated in patients with SRV remodeling and this elevation may have a predictive value. METHODS: We prospectively evaluated 56 patients with D-TGA after the atrial switch procedure (mean age 25.6 ± 4.8, range 18-37 years; 67% males). Serum levels of procollagen type III amino-terminal propeptide (PIIINP), collagen type I carboxy-terminal telopeptide (CITP), procollagen type I N-terminal propeptide (PINP), matrix metalloproteinase (MMP 1, MMP 9) and a tissue inhibitor of matrix metalloproteinase (TIMP 1) and N-terminal pro-brain natriuretic peptide (NT-pro-BNP) were measured and compared with healthy controls. The relationship between these serum markers, echocardiographic and cardiac magnetic resonance parameters and the outcome at a follow-up of 61 months (range, 24-85 months) was determined. RESULTS: Compared with the healthy control group, the study group had significantly higher levels of TIMP1, PIIINP, CITP, PINP and NT-pro-BNP (p<0.05, each). The levels of PIIINP and CITP were significantly higher among patients with an SRV mass index above the mean value. The level of PIIINP was significantly higher among patients with an SRV EDV index above the mean value. CITP was significantly elevated in SRV late gadolinium enhanced (LGE) positive patients, compared to patients without SRV LGE. MMP9 and TIMP1 predicted an adverse clinical outcome on univariate Cox proportional hazard survival analysis in addition to well proven predictors of outcome (SRV EF and NYHA). CONCLUSIONS: We demonstrated a pattern of altered collagen turnover adversely related with the indices of SRV remodeling and an adverse clinical outcome in patients with SRV.
No takes yet. Share an insight, caveat, or question.
Lipczyńska et al. (2017) conducted a cross-sectional in D-transposition of the great arteries (D-TGA) after atrial switch procedure (n=85). Collagen turnover biomarkers assessment vs. Healthy controls was evaluated on Serum PIIINP levels (μg/l) (p=<0.0001). Patients with D-TGA after the atrial switch procedure had significantly higher serum levels of PIIINP compared to healthy controls (4.8 vs 3.3 μg/l, p<0.0001), indicating altered collagen turnover.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: