Significance of the metabolic phenotype and serum procollagens for the formation of postinfarction myocardial fibrosis in patients with preserved ejection fraction

Authors: Osokina A.V., Karetnikova V.N., Polikutina O.M., Pecherina T.B., Gruzdeva O.V., Dyleva Yu.A., Kokov A.N., Brel’ N.K., Barbarash O.L.

Company: Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russian Federation

For correspondence:  Sign in or register.

Type:  Original articles


DOI: https://doi.org/10.24022/1997-3187-2021-15-2-194-2

For citation: Osokina A.V., Karetnikova V.N., Polikutina O.M., Pecherina T.B., Gruzdeva O.V., Dyleva Yu.A., Kokov A.N., Brel’ N.K., Barbarash O.L. Significance of the metabolic phenotype and serum procollagens for the formation of postinfarction myocardial fibrosis in patients with preserved ejection fraction. Creative Cardiology. 2021; 15 (2): 194–206 (in Russ.). DOI: 10.24022/1997-3187-2021-15-2-194-206

Received / Accepted:  01.11.2020 / 28.06.2021

Keywords: myocardial infarction cardiofibrosis fibrosis markers metabolic phenotype

Full text:  

 

Abstract

Objectives. To evaluate the value of the visceral obesity index (IVO), N-terminal procollagen type III propeptide (PIIINP), and C-terminal procollagen type I propeptide (PICP) in the formation of cardiofibrosis one year after ST-segment elevation myocardial infarction (STEMI) with percutaneous coronary intervention (PCI) and preserved ejection fraction (EF).

Material and methods. 86 patients with STEMI and preserved left ventricular EF were examined. Each of them underwent coronary angiography with stenting of a symptom-dependent artery. On the first day of hospitalization and 1 year later IVO was calculated, the concentration of PIIINP, PICP was determined in the venous blood serum. At the one year follow-up, late gadolinium enhancement magnetic resonance imaging was performed to detect cardiofibrosis value.

Results. Depending on IVO, the sample was divided into groups: with a normal value (n=63, 73.3%), increased (n=23, 26.7%). The levels of PIIINP were high in all group of patients in comparison with control group at all points of determination (p<0.001). In 1 year follow-up both groups were divided according to the presence of cardiofibrosis. Among patients with a normal IVO value, 42 (66.7%) people with cardiofibrosis and 21 (33.3%) people without cardiofibrosis were noted. Among individuals with increased IVO, 13 (56.5%) patients with cardiofibrosis and 10 (43.5%) without cardiofibrosis were identified. The highest concentration of PIIINP was found in the group with increased IVO without cardiofibrosis. In groups with normal IVO without cardiofibrosis and with cardiofibrosis, the PICP concentration decreased by year (p=0.010 and p<0.001). In the group with increased IVR without cardiofibrosis and with cardiofibrosis, a decrease in PICP concentration was also revealed after a year (p=0.027 and p=0.043).

Conclusion. The prognostic significance of an increase in the concentration of PIIINP and fasting glycemia on the 1st day of STEMI with preserved EF against the background of increased IVO and body mass index for the formation of cardiofibrosis in a year was established.

References

  1. Plourde B., Sarrazin J., Nault I., Poirier P. Sudden cardiac death and obesity. Exp. Rev. Cardiovasc. Ther. 2014; 12 (9): 1099–1
  2. Arutyunov G.P., Babak S.L., Vasyuk Yu.A., Vertkin A.L., Drapkina O.M., Lopatin Yu.M., et al. Diagnosis, treatment, prevention of obesity and associated diseases. National clinical guidelines. St. Petersburg; 2017: 3–164 (in Russ.).
  3. Artham S.M., Lavie C.J., Patel H.M., Ventura H.O. Impact of obesity on the risk of heart failure and its prognosis. Cardiomet. Synd. 2008; 3 (3): 155–61. DOI: 10.1111/j.1559-4572.2008.00001.x
  4. Yu J., Oh P.C., Kim M., Moon J., Park Y.M., Lee K. et al. Improved early risk stratification of patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention using a combination of serum soluble ST2 and NT-proBNP. PLoS One. 2017; 12 (8): e0182829. DOI: 10.1371/journal.pone.0182829
  5. Drapkina O.M., Gegenava B.B. N-terminal propeptide of collagen type III as a proposed marker of myocardial fibrosis in type 2 diabetes. Cardiovascular Therapy and Prevention. 2018; 17 (3): 17–21 (in Russ.). DOI:10.15829/1728-8800- 2018-3-17-21
  6. Shilyaeva N.V., Shchukin Yu.V., Limareva L.V., Danil'chenko O.P. Biomarkers of myocardial stress and fibrosis for clinical outcomes assessment in post myocardial infarction heart failure patients. Russian Journal of Cardiology. 2018; 23 (1): 32–6 (in Russ.). DOI: 10.15829/1560-4071-2018-1-32-36
  7. Barbarash O.L., Gruzdeva O.V., Pecherina T.B., Akbasheva O.E., Borodkina D.A., Kashtalap V.V. et al. Predictors of myocardial fibrosis and loss of epicardial adipose tissue volume in the long-term period after myocardial infarction. Russian Journal of Cardiology. 2020; 25 (2): 31–40 (in Russ.). DOI: 10.15829/1560-4071-2020-2-3474
  8. Putyatina A.N., Kim L.B. Cardiac extracellular matrix and postinfarction reparative fibrosis (part 1). Vestnik of Northern (Arctic) Federal University. Series: Medical and Biological Sciences. 2016; 4: 54–66 (in Russ.).
  9. Galagudza M.M., Borshchev Yu.Yu., Ivanov S.V. Abdominal visceral obesity as the basis for the formation of metabolic syndrome: current state of the problem. University Therapeutic Journal. 2020; 2 (1): 30–6 (in Russ.).
  10. Osokina A.V., Karetnikova V.N., Polikutina O.M., Slepynina Yu.S., Gruzdeva O.V., Artemova T.P. et al. Procollagen propeptides and visceral obesity index in patients with myocardial infarction with preserved emission faction and various metabolic phenotype. Translational Medicine. 2020; 7 (1): 22–32 (in Russ.). DOI: 10.18705/2311-4495-2020-7-1-22-32
  11. Drapkina O.M., Zyatenkova E.V. Assessment of the N-terminal collagen III-type propeptide in patients with chronic heart failure and metabolic syndrome. Cardiovascular Therapy and Prevention. 2015; 14 (6): 42–7 (in Russ.). DOI: 10.15829/1728-8800-2015-6-42-47
  12. Chumakova G.A., Veselovskaya N.G. Methods of visceral obesity assessment in clinical practice. Russian Journal of Cardiology. 2016; 21 (4): 89–96 (in Russ.). DOI:10.15829/1560-4071-2016-4-89- 96
  13. Maruo S., Motoyama K., Hirota T., Kakutani Y., Yamazaki Y., Morioka T. et al. Visceral adiposity is associated with the discrepancy between glycated albumin and HbA1c in type 2 diabetes. Diabetol. Int. 2020; 11: 368–75. DOI: 10.1007/s13340-020-00431-z
  14. Osokina A.V., Karetnikova V.N., Polikutina O.V., Ivanova A.V., Gruzdeva O.V., Ryzhenkova S.A. et al. In-hospital changes of echocardiographic parameters and their relationship with the procollagen I C-terminal propeptide in patients with myocardial infarction and preserved left ventricle systolic function. Russian Journal of Cardiology. 2020; 25 (2): 45–51 (in Russ.). DOI: 10.15829/1560-4071-2020-2-3553
  15. Tarimov K.O., Subbotkin M.V., Kulanova A.A., Petrenko V.I., Kubyshkin A.V., Fomochkina I.I. et al. Comparative analysis of cardiovascular system morphofunctional disorders' correction in a simulated metabolic syndrome. Obesity and Metabolism. 2020; 17 (2): 208–19 (in Russ.). DOI: 10.14341/omet12296

About Authors

  • Anastasiya V. Osokina, Cand. Med. Sci., Senior Researcher; ORCID
  • Viktoriya N. Karetnikova, Dr. Med. Sci., Professor, Head of Laboratory; ORCID
  • Ol'ga M. Polikutina, Dr. Med. Sci., Leading Researcher; ORCID
  • Tamara B. Pecherina, Cand. Med. Sci., Senior Researcher; ORCID
  • Ol'ga V. Gruzdeva, Dr. Med. Sci., Head of Laboratory; ORCID
  • Yuliya A. Dyleva, Cand. Med. Sci., Senior Researcher; ORCID
  • Aleksandr N. Kokov, Dr. Med. Sci., Head of Laboratory; ORCID
  • Natal'ya K. Brel', Radiologist; ORCID
  • Ol’ga L. Barbarash, Dr. Med. Sci., Professor, Corresponding Member of RAS, Director; ORCID

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery