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Atrial natriuretic peptide, B-type natriuretic peptide, and serum collagen markers after acute myocardial infarction

Departments of ¹Internal Medicine and ²Clinical Chemistry, Kuopio University Hospital, 70211 Kuopio; Departments of ³Internal Medicine and ⁴Clinical Chemistry, Oulu University Hospital, and Departments of ⁵Physiology and ⁶Pharmacology and Toxicology, University of Oulu, 90014 Oulu, Finland

Submitted 27 May 2003 ; accepted in final form 5 November 2003

Experimental data suggest that atrial natriuretic peptide (ANP) and B-type natriuretic peptide (BNP) act locally as antifibrotic factors in heart. We investigated the interrelationships of natriuretic peptides and collagen markers in 93 patients receiving thrombolytic treatment for their first acute myocardial infarction (AMI). Collagen formation following AMI, evaluated as serum levels of amino terminal propeptide of type III procollagen, correlated with NH₂-terminal proANP (r = 0.45, P < 0.001), BNP (r = 0.55, P < 0.001) and NH₂-terminal proBNP (r = 0.50, P < 0.01) on day 4 after thrombolysis. Levels of intact amino terminal propeptide of type I procollagen decreased by 34% (P < 0.001), and levels of carboxy terminal cross-linked telopeptide of type I collagen (ICTP) increased by 65% (P < 0.001). ICTP levels correlated with NH₂-terminal proBNP (r = 0.25, P < 0.05) and BNP (r = 0.28, P < 0.05) on day 4. Our results suggest that ANP and BNP may act as regulators of collagen scar formation and left ventricular remodeling after AMI in humans. Furthermore, degradation of type I collagen is increased after AMI and may be regulated by BNP.

collagen metabolism; remodeling

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