AN ASSOCIATION OF BIOMARKERS OF CARDIAC REMODELING, MYOCARDIAL FIBROSIS AND INFLAMMATION WITH THE PARAMETERS OF HEART FUNCTION AND STRUCTURE IN THE PATIENTS WITH ARTERIAL HYPERTENSION

Backround: An early evaluation of the cardiac remodeling may be usefull in the prediction of heart failure development in the patients with arterial hypertension.
Study objective: to evalute the association of cardiac biomarkers levels with the parameters of cardiac structure and function in the patients with arterial hypertension.
Patients and methods: Patients with arterial hypertension with normal left ventricular ejection fraction (LV EF) and absence of signs of heart failure were included in the study. The levels of biomarkers: NT-proBNP, sST2, Galectin-3, GDF-15, Cystatin C, TIMP-1 and ceruloplasmin were measured and assessed together with other biochemical and echocardiographic parameters.
Results: Total number of 92 patients (61 % men) with mean age 61.5 years were included in the study. Mean LV EF was 64.7 % and mean LV mass index was 91.7 g/m2.
NT-proBNP level correlated significantly with the parameters of LV diastolic function: velocity of E wave (r = 0.377, p < 0.002), and with E/A ratio, (r = 0.455, p < 0.0001), with E lat (r = -0.354, p = 0.006), E/E´ ratio, r = 0.393, p < 0.002, with ePAP (r = 0.390, p = 0.014), and with age (r = 0,384, p < 0.0001). 
In comparison of patients with and without left ventricular hypertrophy, statistically significant differences were found only in LA (p < 0.0001) and sST2 (p = 0.004).
In a multivariate logistic regression, sST2 and TIMP were independent predictors of left ventricular hypertrophy.

Conclusion: NT-proBNP level as a biomarker of cardiac remodeling correlates in the patients with arterial hypertension with the parameters of LV diastolic function. Soluble ST2 correlates with parameters of cardiac structure. Biomarkers sST2 and TIMP-1 are associated with left ventricular hypertrophy.