Background: The aim of the study was to assess the correlation of the selected biomarkers and collagen turn-over indices with advanced echocardiographic parameters among patients with preserved and reduced ejection fraction (EF .6). Clinical evaluation included 6-min walk test, biochemistry, procollagen type I N-terminal propeptide (PINP), procollagen type III N-terminal propetide (PIIINP), matrix metaloproteinase-2 (MMP2), ghrelin, and galectin-3 levels measurements. Echocardiographic examination was performed with analysis of diastolic function and global longitudinal strain (GLS). Results: The GLS in the HFrEF group was significantly lower than in the HFpEF group at the baseline (GLS: 9.56 vs. 16.03, p < 0.01). There was a strong negative correlation of the p = 0.005), but only a moderate negative correlation in p = 0.02). In the HFrEF group, there was a moderate negative correlation between the baseline level of p = 0.03). The correlation of ghrelin and tissue inhibitor of matrix metalloproteinase-1 with EF in the HFrEF group was moderate and statistically significant (r = 0.62, p = 0.02 and r = -0.63, p = 0.02, respectively). Conclusions: Procollagen type III peptide has a strong negative correlation with left ventricular GLS. Galectin-3 relationship with strain may indicate novel pathophysiological pathways and requires further investigation. (Cardiol J 2017; 24, 1: 35-42)

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