{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T06:34:53Z","timestamp":1778740493056,"version":"3.51.4"},"reference-count":26,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T00:00:00Z","timestamp":1693526400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Instituto de Salud Carlos III","award":["CB16\/11\/00483"],"award-info":[{"award-number":["CB16\/11\/00483"]}]},{"name":"Instituto de Salud Carlos III","award":["PI18\/01469"],"award-info":[{"award-number":["PI18\/01469"]}]},{"name":"Instituto de Salud Carlos III","award":["PI21\/00946"],"award-info":[{"award-number":["PI21\/00946"]}]},{"name":"Instituto de Salud Carlos III","award":["305507"],"award-info":[{"award-number":["305507"]}]},{"name":"Kootstra Talented Post-Doctoral Fellowship","award":["CB16\/11\/00483"],"award-info":[{"award-number":["CB16\/11\/00483"]}]},{"name":"Kootstra Talented Post-Doctoral Fellowship","award":["PI18\/01469"],"award-info":[{"award-number":["PI18\/01469"]}]},{"name":"Kootstra Talented Post-Doctoral Fellowship","award":["PI21\/00946"],"award-info":[{"award-number":["PI21\/00946"]}]},{"name":"Kootstra Talented Post-Doctoral Fellowship","award":["305507"],"award-info":[{"award-number":["305507"]}]},{"name":"European Union Commission\u2019s Seventh Framework Program","award":["CB16\/11\/00483"],"award-info":[{"award-number":["CB16\/11\/00483"]}]},{"name":"European Union Commission\u2019s Seventh Framework Program","award":["PI18\/01469"],"award-info":[{"award-number":["PI18\/01469"]}]},{"name":"European Union Commission\u2019s Seventh Framework Program","award":["PI21\/00946"],"award-info":[{"award-number":["PI21\/00946"]}]},{"name":"European Union Commission\u2019s Seventh Framework Program","award":["305507"],"award-info":[{"award-number":["305507"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Collagen cross-linking is a fundamental process in dilated cardiomyopathy (DCM) and occurs when collagen deposition exceeds degradation, leading to impaired prognosis. This study investigated the associations of collagen-metabolism biomarkers with left ventricular function and prognosis in DCM. Methods: DCM patients who underwent endomyocardial biopsy, blood sampling, and cardiac MRI were included. The primary endpoint included death, heart failure hospitalization, or life-threatening arrhythmias, with a follow-up of 6 years (5\u20138). Results: In total, 209 DCM patients were included (aged 54 \u00b1 13 years, 65% male). No associations were observed between collagen volume fraction, circulating carboxy-terminal propeptide of procollagen type-I (PICP), or collagen type I carboxy-terminal telopeptide [CITP] and matrix metalloproteinase [MMP]-1 ratio and cardiac function parameters. However, CITP:MMP-1 was significantly correlated with global longitudinal strain (GLS) in the total study sample (R = \u22120.40, p &lt; 0.0001; lower CITP:MMP-1 ratio was associated with impaired GLS), with even stronger correlations in patients with LVEF &gt; 40% (R = \u22120.70, p &lt; 0.0001). Forty-seven (22%) patients reached the primary endpoint. Higher MMP-1 levels were associated with a worse outcome, even after adjustment for clinical and imaging predictors (1.026, 95% CI 1.002\u20131.051, p = 0.037), but CITP and CITP:MMP-1 were not. Combining MMP-1 and PICP improved the goodness-of-fit (LHR36.67, p = 0.004). Conclusion: The degree of myocardial cross-linking (CITP:MMP-1) is associated with myocardial longitudinal contraction, and MMP-1 is an independent predictor of outcome in DCM patients.<\/jats:p>","DOI":"10.3390\/jcm12175695","type":"journal-article","created":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T09:12:22Z","timestamp":1693559542000},"page":"5695","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Biomarkers of Collagen Metabolism Are Associated with Left Ventricular Function and Prognosis in Dilated Cardiomyopathy: A Multi-Modal Study"],"prefix":"10.3390","volume":"12","author":[{"given":"Anne","family":"Raafs","sequence":"first","affiliation":[{"name":"Department of Cardiology, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands"},{"name":"Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, 6229 HX Maastricht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4409-6206","authenticated-orcid":false,"given":"Bouke","family":"Adriaans","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands"},{"name":"Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, 6229 HX Maastricht, The Netherlands"},{"name":"Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michiel","family":"Henkens","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands"},{"name":"Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, 6229 HX Maastricht, The Netherlands"},{"name":"Netherlands Heart Institute (NLHI), 3511 EP Utrecht, The Netherlands"},{"name":"Department of Pathology, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5549-1298","authenticated-orcid":false,"given":"Job","family":"Verdonschot","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands"},{"name":"Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, 6229 HX Maastricht, The Netherlands"},{"name":"Department of Clinical Genetics, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Myrurgia","family":"Abdul Hamid","sequence":"additional","affiliation":[{"name":"Department of Pathology, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javier","family":"D\u00edez","sequence":"additional","affiliation":[{"name":"Program of Cardiovascular Diseases, CIMA Universidad de Navarra and IdiSNA, 31008 Pamplona, Spain"},{"name":"CIBERCV, Carlos III Institute of Health, 28029 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Knackstedt","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vanessa","family":"van Empel","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hans-Peter","family":"Brunner-La Rocca","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arantxa","family":"Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Program of Cardiovascular Diseases, CIMA Universidad de Navarra and IdiSNA, 31008 Pamplona, Spain"},{"name":"CIBERCV, Carlos III Institute of Health, 28029 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joachim","family":"Wildberger","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, 6229 HX Maastricht, The Netherlands"},{"name":"Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephane","family":"Heymans","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands"},{"name":"Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, 6229 HX Maastricht, The Netherlands"},{"name":"Department of Cardiovascular Research, University of Leuven, 3000 Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Hazebroek","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands"},{"name":"Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, 6229 HX Maastricht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,9,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e012514","DOI":"10.1161\/JAHA.119.012514","article-title":"Role of Targeted Therapy in Dilated Cardiomyopathy: The Challenging Road Toward a Personalized 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Heart Fail."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/17\/5695\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:44:30Z","timestamp":1760129070000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/17\/5695"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,1]]},"references-count":26,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2023,9]]}},"alternative-id":["jcm12175695"],"URL":"https:\/\/doi.org\/10.3390\/jcm12175695","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,1]]}}}