2009 年 73 巻 1 号 p. 100-105
Background Myocardial fibrosis is a feature of diastolic dysfunction and target organ damage, which was compared among subjects with normotension (NT), white-coat hypertension (WCH) and essential hypertension (EH). Serum procollagen type I propeptide (PIP) level was assessed as a marker of diastolic dysfunction in WCH. Methods and Results Of 90 subjects, 30 had NT and 30 had WCH (ambulatory daytime blood pressure <135/85 mmHg) and 30 had EH (untreated mild to moderate hypertension); all underwent biochemical and echocardiographic examinations. Those with WCH had a lower left ventricular (LV) mass index than those with EH, but it was higher than in the NT group. WCH patients had a lower mitral valve E/A ratio and a higher LV E/E' (E': septal mitral annular peak velocity) ratio than NT patients, whereas these values were higher and lower respectively than in the EH group. The LV E/E' ratio, an estimate of LV diastolic function, correlated with the serum PIP concentration in WCH patients (r=0.39, P=0.03). Conclusion WCH is an intermediate group between NT and EH in respect of target organ damage. These results show a relationship between LV diastolic function and serum PIP in WCH, so the serum PIP level may be a useful marker of diastolic dysfunction and target organ damage in such patients. (Circ J 2009; 73: 100 - 105)
