0139: Detection of myocardial fibrosis in patients with hypertrophic cardiomyopathy evaluated by biological markers

Abstract

Hypertrophic cardiomyopathy (HCM) is a disease characterized by cell disorganization with a matrix remodeling leading to fibrosis. The purpose of our study was to investigate biological markers which are the amino terminal pro peptide of type III collagen (PIIINP), a metalloproteinase (MMP3) involved in the regulation collagen and its specific tissue inhibitor TIPM2. We included 107 patients and 175 controls. We studied the association of serum levels of these markers with clinical, echocardiographic and prognostic parameters. In the study population, the mean age was 49 years, 60 were male, 75% were symptomatic (palpitations in 38% of cases, chest pain in 28% of cases, syncope in 25% of cases) the rate of PIIINP was significantly higher in patients compared with controls (361.92±41.6pg/mL vs 242.80±46.7ng/ml; p=0.036). Same for themmP3 and TIMP2 levels (12.16±4.3pg/mL vs 10.4±3.78pg/mL and 63.4±23.5pg/mL vs 57.50±21.43pg/mL, respectively, p=0.03). We note that themmP3 / TIMP2 ratio is correlated to left ventricular (LV) mass and the left atrium volume (r=0.560, p=0.002, and r=0.633, p=0.001 rspectively), the PIIINP is correlates to the maximum thickness of the LV (r=0.466, p=0.002), to the global longitudinal Strain of the LV and its mass (r=0.578, r=0.001 and r=0.490, p=0.003 respectively). Patients with a history of syncope and episodes of non-sustained ventricular tachycardia, were younger and had a significantly higher rate of PIIINP (432.5±34.6pg/mL vs 320.44±32.8pg/mL, p=0.002) and less LV GLS (-14.7±2.6% vs 16.7±3.2%, p=0.0034). HCM is characterized by ventricular and atrial remodeling and fibrosis related to the collagen accumulation that is reflected bymmP3/ TIMP2 ratio serum and the PIIINP concentration. These parameters were correlated with LV function may represent potential risk factors for the ventricular dysrhythmia and LV dysfunction.