Background: We evaluated the value of BNP and collagen markers, and relationship with left ventricular hypertrophy (LVH) and dilatation in hypertensive heart disease.
Methods: We measured plasma levels of BNP (Biosite), collagen degradation markers (MMP-1, TIMP-1 and ICTP) and collagen synthesis markers (type I or III procollagen: PINP or PIIINP) in 87 patients with newly developed HHD (onset ≤ 1month). LVH was defined by echocardiography. Normal controls were volunteer without any disease history (group I, n=15). We divided the patients into HTN without LVH (group II, n=21), with LVH (group III, n=24) and with reduced LV systolic function and dilated LV dimension (group IV, n=28, EF <40% & LVEDD >5.5cm). We excluded the patients with diabetes, atrial fibrillation, coronary artery disease, renal disease, abnormal liver function and bone or connective tissue disorders. Results: 1. LVMI (g/m2) were significant differences among groups (group I; 102±22, II; 105±31, III; 146±29, IV; 167±28, p<0.05). BNP were significant differences among groups (17±11, 24±32, 58±39, 198±108 pg/ml, p<0.05). 2. MMP-1, TIMP-1, MMP-1/TIMP-1 ratio & ICTP were significant increased in group II, III and group IV than group I (p<0.05, respectively) and in HF patients, MMP-1/TIMP-1 ratio & ICTP were significant increased than in HTN group (p<0.05). PINP & PIIINP were increased in group II, III, IV and, there were not significant difference between HTN and HF group (p>0.05). 3. Only BNP level was significant difference between group II and group III (p<0.05). Increased BNP levels were associated with LV mass index (p<0.01), EF (p<0.05) and the E/A ratio of transmitral flow (p<0.05). The accuracy using a cut-off value in diagnosing LVH were 0.94 at BNP 38 pg/ml (p=0.042). LVH was related to the BNP (p=0.018). LVEDD had a significant correlation with MMP-1 (r=0.312, p<0.05), MMP-1/TIMP-1(r=0.362, p<0.05) and ICTP (r=0.309, p<0.05). Conclusion: Our results suggest that BNP and serum markers of collagen degradation may act as LV remodeling process. In hypertensive heart disease, BNP are closely related to LVH and serum markers of collagen degradation are close related to LV dilation.
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