Serum levels of collagen type-I degradation markers are associated with vascular stiffness in chronic heart failure patients

Background: Chronic heart failure (CHF) induces peripheral vasoconstriction, endothelial dysfunction and arterial stiffness by activation of various neurohormonal pathways. The abnormal collagen turnover observed in CHF may be attributed not only to myocardial remodelling, but also to vascular remodelling. However, the effect of collagen metabolism on progressive large artery stiffening in the setting of CHF is understudied. Aims: The present study was undertaken to investigate the association between circulating markers of collagen turnover and vascular stiffness in patients with CHF. Methods: Eighty patients (mean age 65 +/- 11 years, 68 men) with stable CHF and in sinus rhythm, were studied. Serum concentrations of carboxy-terminal telopeptide of collagen type I (CITP) and amino-terminal propetide of procollagen type I (PINP), markers of collagen type I degregation and synthesis respectively, were measured in all patients. Pulse wave velocity (PWV) and augmentation index (AIx) of aortic pulse wave form, markers of arterial stiffness, were also determined by applanation tonometry. Results: Peripheral PAW was inversely associated with serum CITP levels (r = -0.585, p < 0.001). AIx although weakly was negatively correlated with serum CITP levels (r = -0.285, p = 0.01). Multiple regression analysis showed that peripheral PWV remained independently associated with serum CITP levels after adjustment for all confounding variables. Conclusions: Findings from the present study imply a possible link between altered collagen metabolism and peripheral vascular stiffness in CHF. (C) 2008 European Society of Cardiology. Published by Elsevier B.V. All tights reserved.