Key result
Serum PICP, a biomarker of myocardial collagen synthesis, was independently associated with coexisting atrial fibrillation in patients with systolic heart failure (OR per 1 μg/L change 1.01, P=0.012).
Why the study?
Are biomarkers of myocardial fibrosis associated with coexisting atrial fibrillation in patients with systolic heart failure?
Cross-Sectional (n=143)
Are biomarkers of myocardial fibrosis associated with coexisting atrial fibrillation in patients with systolic heart failure?
Odds Ratio: 1.01
p-value: p=0.012
In patients with systolic heart failure, altered collagen type-I metabolism (elevated PICP) is independently associated with coexisting atrial fibrillation, suggesting more severe fibrotic remodeling.
PICP-AF association in systolic HF is hypothesis-generating; prospective studies needed before any clinical consideration.
OBJECTIVES: Alterations of collagen metabolism present in heart failure promote the fibrotic substrate for the development of atrial fibrillation (AF). Myocardial collagen I synthesis and degradation can be assessed indirectly by circulating biomarkers such as the carboxy terminal propeptide (PICP) and carboxy-terminal telopeptide (CITP), respectively. DESIGN: We examined myocardial collagen type-I metabolism in 143 patients with systolic heart failure (New York Heart Association Class 2-4) in relation to coexisting AF. RESULTS: Mean age was 75 years, blood pressure 134/80 mm Hg, ejection fraction 34%, serum PICP 81 μg/L and CITP 8.3 μg/L, and median plasma brain natriuretic peptide 215 pg/L; 77 were in AF. PICP and CITP were related to left atrial diameter (r = 0.22, P = 0.013, and r = 0.26, P = 0.003) and CITP to pulmonary capillary wedge pressure and C-reactive protein (r = 0.19, P = 0.044, and r = 0.29, P = 0.003). A logistic regression suggested that PICP (odds ratio per 1 μg/L change 1.01, P = 0.012) and left ventricular end-diastolic volume (odds ratio per 1 mL change 0.98, P < 0.001) were independently associated with coexisting AF. CONCLUSION: Collagen type-I metabolism is associated to left atrial size. Heart failure patients with coexisting AF exhibit more altered collagen type-I metabolism than patients in sinus rhythm. This might represent more severe atrial and ventricular fibrosis.
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Löfsjögård et al. (2014) conducted a cross-sectional in systolic heart failure (n=143). Serum carboxy terminal propeptide (PICP) was evaluated on coexisting atrial fibrillation (OR 1.01, p=0.012). Serum PICP, a biomarker of myocardial collagen synthesis, was independently associated with coexisting atrial fibrillation in patients with systolic heart failure (OR per 1 μg/L change 1.01, P=0.012).
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