Previous studies indicated an association of biomark- ers reflecting collagen turnover with heart failure. 1,2 How- ever, their value in predicting unfavorable outcomes is unknown.Inthemyocardium,thecollagenmatrixformsa scaffold that maintains the anatomical integrity and func- tion of the heart. Collagen I is dominant among the four primary types of cardiac collagen. 3 The abundance of col- lagenisthenetresultofthebalancebetweensynthesisand degradation. 4,5 Collagendegradationreleasesfragmentsto the circulation and urine. Here, we investigate if specific changes in collagen I turnover, detected based on urinary peptide fragments and circulating biomarkers, are associ- ated with heart failure and subsequent clinical events.
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