Effects of chronic inflammatory bowel diseases on left ventricular structure and function : dottorato di ricerca in fisiopatologia chirurgica

Background: Experimental evidences suggest an increased collagen deposition in inflammatory bowel diseases (IBD). In the hypothesis that chronic inflammation and increased collagen metabolism are reflected also in the systemic circulation, we aimed this study to evaluate the effects on left ventricular wall structure by assessing splanchnic and systemic collagen metabolism (procollagen III), its deposition (ultrasonic tissue characterization), and cardiac function (echocardiography) in patients with different longstanding history of IBD, before and after surgery.Methods: Twenty-seven patients affected by active IBD, 17 with Crohn and 10 with ulcerative colitis, submitted to surgery were enrolled in the study in a double blind fashion. They were studied before the surgical operation and will be controlled at 6 and 12 months after surgery. A control group of 14 healthy age and gender-matched subjects were also studied. Blood was drawn from a peripheral vein prior to surgery. Immediately before intestinal resection, additional samples were drawn for the mesenteric vein draining the affected intestinal segment . Before surgery a transthoracic echocardiogram was recorded for the subsequent determination of cardiac function and collagen deposition. Results: Before surgery, serum PIIIP level in IBD patients was 5.0 ± 1.9 vs 2.7 ± 0.7 mcg/l of healthy controls (p=0.0001). No significant differences were found when comparing IBD subgroups, respectively Crohn = 5.0 ± 1.6 vs ulcerative colitis = 4.9 ± 2.4 mcg/l, (p=ns). During surgery, serum PIIIP level in IBD patients was 5.5 ± 2.6 mcg/l. No significative differences are found when coumparing the two subgroups, respectively Chron 5.4 +2.3 is ulcerative colits 5.7+3.1 mcg/l, (p=ns). Conclusion : the present study provides evidence that the altered intestinal collagen metabolism in Chrons diseases and ulcerative colits is reflected also in the local systemic circulation.