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KMID : 0648320060120040009
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Journal of The Korean Society of Hypertension
2006 Volume.12 No. 4 p.9 ~ p.15
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Serum Carboxy-terminal Propeptide of Type 1 Procollagen (PIP) is a Marker of Left Ventricular Diastolic Dysfunction and Target Organ Damage in Patients with White Coat Hypertension.
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Ihm Sang-Hyun
Youn Ho-Joong
Kim Hee-Yeol
Chang Ki-Yuk
Baek Sang-Hong
Seung Ki-Bae
Kim Jae-Hyung
Hong Soon-Jo
Choi Kyu-Bo
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Abstract
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Background: We compared target organ status in normotensive (NT), white coat hypertensive (WCH) and established hypertensive (EH) subjects and assessed serum procollagen type I propeptide (PIP) level as a marker of diastolic dysfunction in patients with WCH.
Methods: 30 NT, 30 WCH (ambulatory day time blood pressure < 135/85 mmHg) and 30 EH (untreated mild to moderate hypertension) subjects underwent biochemical and echocardiographic examinations. The serum concentration of PIP, a marker of myocardial fibrosis, was measured by Enzyme immunoassay method.
Results: Compared with EHs, WCHs had significantly lower values of LV mass index (LVMI) (p<0.001). But WCHs had higher values of LVMI than NTs (p=0.02). WCHs showed significantly lower mitral valve (MV) E/A ratio (p=0.03) and higher LV E/E’ (p=0.004) than NTs. But WCHs had higher values of MV E/A ratio (p=0.01) and lower value of LV E/E’ ratio (p=0.04) than EHs. The serum concentration of PIP was significant higher in WCHs than in NTs (P<0.001) but was no difference between WCHs and EHs. LV E/E’ ratio (E: mitral early filling velocity, E’: early diastolic mitral annular velocity by tissue Doppler), an estimate of LV diastolic function, correlates with the serum level of PIP level in WCHs (r=0.39, p=0.03).
Conclusion: Our data indicate that patients with WCH represent an intermediate group between NTs and EHs in the aspect of target organ damage. These results show a relationship between the LV diastolic function and serum level of PIP in patients with WCH. Serum level of PIP may be a useful marker of diastolic dysfunction and target organ damage in patients with WCH.
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KEYWORD
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Hypertension, Procollagen, Myocardial Fibrosis, Echocardiography, Diastole
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