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Amino-terminal propeptide of type III procollagen is associated with restrictive mitral filling pattern in patients with dilated cardiomyopathy: a possible link between diastolic dysfunction and prognosis
  1. A Rossi1,
  2. M Cicoira1,
  3. G Golia1,
  4. L Zanolla1,
  5. L Franceschini1,
  6. P Marino1,
  7. M Graziani2,
  8. P Zardini1
  1. 1Dipartimento di Scienze Biomediche e Chirurgiche, Sezione di Cardiologia, Universita’ degli Studi di Verona, Verona, Italy
  2. 2Laboratorio di Chimica Clinica, Ospedale Civile Maggiore, Verona, Italy
  1. Correspondence to:
    Dr A Rossi
    Divisione Clinicizzata di Cardiologia, Ospedale Civile Maggiore, P le Stefani 1, 37126 Verona, Italy;


Objective: To analyse the relation between restrictive mitral pattern, amino-terminal propeptide of type III procollagen (PIIINP), and prognosis in patients with dilated cardiomyopathy.

Design: Prospective cohort study of 106 patients with dilated cardiomyopathy.

Setting: Tertiary care centre.

Main outcome measures: PIIINP concentration, echocardiographic variables, oxygen consumption, hospitalisation for heart failure, and cardiac mortality were evaluated in patients grouped by the presence of non-restrictive (group 1), reversible (group 2), and irreversible restrictive mitral pattern (group 3).

Results: Groups differed regarding left ventricular ejection fraction (group 1, mean (SD) 36 (6)%, group 2, 29 (8)%, group 3, 25 (6)%; p  =  0.0001), left atrial ejection fraction (group 1, 0.47 (0.1)%, group 2, 0.43 (0.2)%, group 3, 0.26 (0.1)%; p < 0.0001), and PIIINP (p  =  0.001). Multivariate analysis showed that PIIINP was related to mitral pattern (odds ratio 0.8, 95% confidence interval 0.23 to 1.4, p  =  0.006) independently of left atrial and ventricular ejection fractions. After 21 months, survival was 88% and 34% (p  =  0.0001) in patients with non-restrictive and irreversible restrictive mitral patterns, respectively.

Conclusion: In patients with dilated cardiomyopathy, restrictive mitral pattern is associated with higher PIIINP and worse prognosis.

  • collagen
  • diastolic function
  • dilated cardiomyopathy
  • Doppler echocardiography
  • CI, confidence interval
  • DCM, dilated cardiomyopathy
  • PIIINP, amino-terminal propeptide of type III procollagen
  • RF, restrictive ventricular filling
  • o2, oxygen uptake

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