1. Plasma MMP-2, MMP-9 and N-BNP in long-term survivors following complicated myocardial infarction: relation to cardiac magnetic resonance imaging measures of left ventricular structure and function.
- Author
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Orn S, Manhenke C, Squire IB, Ng L, Anand I, and Dickstein K
- Subjects
- Aged, Angiotensin II Type 1 Receptor Blockers therapeutic use, Angiotensin-Converting Enzyme Inhibitors therapeutic use, Biomarkers blood, Captopril therapeutic use, Enzyme-Linked Immunosorbent Assay, Female, Follow-Up Studies, Heart Ventricles pathology, Heart Ventricles physiopathology, Humans, Losartan therapeutic use, Male, Myocardial Infarction drug therapy, Myocardial Infarction physiopathology, Prognosis, Severity of Illness Index, Stroke Volume, Time Factors, Magnetic Resonance Imaging methods, Matrix Metalloproteinase 2 blood, Matrix Metalloproteinase 9 blood, Myocardial Infarction blood, Natriuretic Peptide, Brain blood, Peptide Fragments blood, Ventricular Function, Left physiology, Ventricular Remodeling physiology
- Abstract
Background: Altered activity of the matrix metalloproteinases (MMP-2 and -9), has been implicated in the left ventricular (LV) remodeling process occurring after myocardial infarction (MI). In the acute phase, a relation between plasma MMP-9 levels and parameters of LV dysfunction has been demonstrated. The relationship in long-term survivors has not been investigated. We studied the relationships of these biochemical markers, and N-terminal pro-B-type natriuretic peptide (N-BNP), with measures of long-term LV remodeling., Methods and Results: Plasma levels of N-BNP, MMP-2, and MMP-9 were measured at randomization, 1 month, 1 year, and > 4 years after complicated AMI. Contrast-enhanced cardiac magnetic resonance (CMR) was performed at 4.4 (+/-0.4) years in 52 clinically stable long-term survivors of the index AMI. We assessed the relationships of plasma N-BNP, MMP-2, and MMP-9 with myocardial scarring, and measures of long-term LV remodeling. Compared with a reference population, N-BNP and MMP-9 levels were increased at all time points from the acute phase until > 4 years after MI. Plasma N-BNP and MMP-9 correlated only in the subacute phase (randomization, mean 3.3 days after MI) days after acute MI (r = 0.38, P = .006). At CMR assessment > or = 4 years, log MMP-9 level was inversely related to LV ejection fraction (P = .002) and nonscarred myocardial mass (P = .008). This relationship was independent of MMP-2. Log N-BNP was related to end diastolic volume index (P = .0002). There was no correlation between log MMP-9 and LV volumes., Conclusion: There is a time-dependent relationship between plasma N-BNP and MMP-9 levels, these peptides correlating only in the acute phase after MI. In long-term follow-up, plasma MMP-9 and N-BNP levels were related to different parameters of LV remodeling. These findings suggest that in long-term survivors of complicated MI, different mechanisms modulate plasma levels of MMP-9 and N-BNP.
- Published
- 2007
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