This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Maceira, A. M. Articles by Díez, J. Search for Related Content PubMed PubMed Citation Articles by Maceira, A. M. Articles by Díez, J. Pubmed/NCBI databases Substance via MeSH Medline Plus Health Information Cardiomyopathy High Blood Pressure Related Collections Remodeling Echocardiography Other diagnostic testing

(Hypertension. 2002;39:923.)
© 2002 American Heart Association, Inc.

Scientific Contributions

Ultrasonic Backscatter and Serum Marker of Cardiac Fibrosis in Hypertensives

Alicia M. Maceira; Joaquín Barba; Nerea Varo; Oscar Beloqui; Javier Díez

From the Departments of Cardiology and Cardiovascular Surgery (A.M.M., J.B., J.D.), Clinical Chemistry (N.V.), and Internal Medicine (O.B.), University Clinic of Navarra, University of Navarra, and the Division of Cardiovascular Pathophysiology, School of Medicine (J.D.), University of Navarra, Pamplona, Spain.

Correspondence to Dr Javier Díez, División de Fisiopatología Cardiovascular, Facultad de Medicina, C/Irunlarrea s/n, 31008 Pamplona, Spain. E-mail jadimar{at}unav.es

Elevations in the serum concentration of the carboxy-terminal propeptide of procollagen type I (PIP) >127 µg/L have been found to predict severe myocardial fibrosis in hypertensive patients. This study was designed to assess whether ultrasonic reflectivity, evaluated by a real-time integrated backscatter analysis, was related to the severity of myocardial fibrosis as estimated by serum PIP. Thirty-four subjects were included in the study. Serum PIP was measured by specific radio immunoanalysis. Backscatter cyclic variation and maximal intensity were measured in 6 regions throughout the left ventricle. The subjects were divided into 3 groups: 14 normotensives with PIP <127 µg/L (group 1), 12 hypertensives with PIP <127 µg/L (group 2), and 8 hypertensives with PIP >127 µg/L (group 3). The highest cyclic variation was found in group 1 and the lowest in group 3 (5.78±0.25 versus 4.70±0.33 dB, P<0.05), with intermediate values in group 2 (5.10±0.27 dB). No differences in maximal intensity were found among the 3 groups of subjects. Using receiver operating characteristics curves, we observed that a cutoff of 2.90 dB for cyclic variation measured in the apex provided 75% sensitivity and 63% specificity for predicting PIP >127 µg/L in hypertensives, with a relative risk of 2.50 (95% CI, 0.72 to 34.70). These results show an association between diminished cyclic variation of backscatter and increased serum concentration of PIP in hypertension. Thus, the combination of these 2 parameters may be useful for the diagnosis of severe myocardial fibrosis associated with hypertension.

Key Words: collagen • hypertension, essential • fibrosis • peptides • ultrasonography

This article has been cited by other articles:

				A. Gonzalez, B. Lopez, S. Ravassa, J. Beaumont, T. Arias, N. Hermida, A. Zudaire, and J. Diez Biochemical markers of myocardial remodelling in hypertensive heart disease Cardiovasc Res, February 15, 2009; 81(3): 509 - 518. [Abstract] [Full Text] [PDF]

				S. Umar, J. J. Bax, M. Klok, R. J. van Bommel, M. H.M. Hessel, B. den Adel, G. B. Bleeker, M. M. Henneman, D. E. Atsma, E. E. van der Wall, et al. Myocardial collagen metabolism in failing hearts before and during cardiac resynchronization therapy Eur J Heart Fail, September 1, 2008; 10(9): 878 - 883. [Abstract] [Full Text] [PDF]

				M. Salvetti, M. L. Muiesan, A. Paini, C. Monteduro, B. Bonzi, G. Galbassini, E. Belotti, E. Movilli, G. Cancarini, and E. Agabiti-Rosei Myocardial Ultrasound Tissue Characterization in Patients with Chronic Renal Failure J. Am. Soc. Nephrol., June 1, 2007; 18(6): 1953 - 1958. [Abstract] [Full Text] [PDF]

				T. Ohtsuka, K. Inoue, Y. Hara, N. Morioka, K. Ohshima, J. Suzuki, A. Ogimoto, Y. Shigematsu, and J. Higaki Serum markers of angiogenesis and myocardial ultrasonic tissue characterization in patients with dilated cardiomyopathy Eur J Heart Fail, June 1, 2005; 7(4): 689 - 695. [Abstract] [Full Text] [PDF]

				M. M. Ciulla, R. Paliotti, A. Esposito, J. Diez, B. Lopez, B. Dahlof, M. G. Nicholls, R. D. Smith, L. Gilles, F. Magrini, et al. Different Effects of Antihypertensive Therapies Based on Losartan or Atenolol on Ultrasound and Biochemical Markers of Myocardial Fibrosis: Results of a Randomized Trial Circulation, August 3, 2004; 110(5): 552 - 557. [Abstract] [Full Text] [PDF]

				V. Di Bello, D. Giorgi, E. Talini, G. Dell' Omo, C. Palagi, M. F. Romano, R. Pedrinelli, and M. Mariani Incremental Value of Ultrasonic Tissue Characterization (Backscatter) in the Evaluation of Left Ventricular Myocardial Structure and Mechanics in Essential Arterial Hypertension Circulation, January 7, 2003; 107(1): 74 - 80. [Abstract] [Full Text] [PDF]

				A. M. Maceira, J. Barba, O. Beloqui, and J. Diez Ultrasonic Backscatter and Diastolic Function in Hypertensive Patients Hypertension, September 1, 2002; 40(3): 239 - 243. [Abstract] [Full Text] [PDF]