Fibrosis markers in metabolic syndrome
Drapkina О.М.¹, Zyatenkova Е.V.<sup>2

1</sup> National Research Center of Preventive Medicine, Moscow
² I.M. Sechenov First Moscow State Medical University

Obesity and disorders of lipid and carbohydrate metabolism promote the development and progression of chronic heart failure (CHF). The key factor of CHF pathogenesis and progression is cardiac remodeling. N-terminal propeptide of collagen type III (PIIINP) is a prospective marker of cardiac remodeling and CHF development.
Aim. To study the association between PIIINP and clinical manifestations of CHF, anatomy and functions of myocardium in patients with CHF and metabolic syndrome.
Patients and methods. 77 patients with CHF were enrolled in the study. CHF diagnosis was verified by NT-pro BNP measurements. Study group included 39 patients with CHF and metabolic syndrome. Control group included 38 patients with CHF only (without metabolic syndrome). The severity of CHF symptoms and functional status were assessed. Common blood tests, blood biochemistry, and ECG were performed in a total of 77 patients. Cardiac chamber sizes, myocardial wall and epicardial fat thickness were evaluated by echo cardiography.
Results. PIIINP levels in the study and control groups were 3.3 ± 1.5 µg/L and 2.3 ± 1.3 µg/L, respectively (p = 0.00046). Statistical analysis revealed significant correlations between PIIINP and lab tests, i.e., uric acid (r = 0.37, p = 0.001), glucose (r = 0.29, p = 0.011), and GFR (r = -0.37, p = 0.002); and PIIINP and echo cardiography parameters, i.e., epicardial fat thickness (r = 0.33, p = 0.004), ventricular septum thickness (r = 0.33, p = 0.003), left ventricular myocardial mass (r = 0.36, p = 0.002), right atrium size (r = 0.34, p = 0.043), left atrium size (r = 0.35, p = 0.034), left ventricle end-systolic size (r = 0.31, p = 0.006), E/A ratio (r = 0.28, p = 0.013), and Е/е ratio (r = 0.24, p = 0.038).
Conclusions. PIIINP might identify patients with early CHF and metabolic syndrome accompanied by structural and functional cardiac changes.

Key words: chronic heart failure, metabolic syndrome, fibrosis, N-terminal propeptide of collagen type III, torasemide.

For citation: Drapkina О.М., Zyatenkova Е.V. Fibrosis markers in metabolic syndrome // RMJ. 2016. № 26. P. 1727–1731.