Biomarkers in hypertensive heart disease

Abstract

Changes in the composition of cardiac tissue develop in arterial hypertension and lead to structural remodelling of the myocardium. Cardiomyocyte hypertrophy and apoptosis, fibrous tissue accumulation within the myocardial interstitium and wall hypertrophy of the microvasculature are alterations of the adverse structural remodeling of cardiac tissue seen with hypertensive heart disease. Its clinical relevance is that it might contribute to the myocardial dysfunction and failure, therefore noninvasive monitoring of myocardial remodeling by using circulating markers could prove a clinically useful tool. Emerging evidences hold promise for the use of various markers of cellular response to biomechanical stress (i.e, cardiotrophin-1 and natriuretic peptides), cardiac apoptosis (i.e, annexin V) and fibrillar collagen synthesis and degradation (i.e., carboxy-terminal propeptide of procollagen type I and matrix metalloproteinase and its inhibitory system) in arterial hypertension. Available data set the stage for larger trials, where noninvasive measures of myocardial remodeling could prove useful for handling of patients with hypertensive heart disease.