Hansson Jonas, Lind Lars, Hulthe Johannes, Sundström Johan
Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
Eur J Cardiovasc Prev Rehabil. 2009 Jun;16(3):297-303. doi: 10.1097/HJR.0b013e3283213108.
Extracellular matrix remodeling is a hallmark of pathological left ventricular (LV) hypertrophy and heart failure. This process is tightly controlled by the degrading matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs). We hypothesized that circulating MMP-9 and TIMP-1 levels are altered already in persons with the signs of LV remodeling that forego clinical heart failure.
Cross-sectional study in the Prospective Investigation of the Vasculature in Uppsala Seniors, a community-based cohort of 891 70-year-old men and women free from valvular disease, heart failure, and myocardial infarction.
We examined relations of serum MMP-9 and TIMP-1 to echocardiographic LV geometry and function. All models were adjusted for sex, height, intra-arterial systolic and diastolic blood pressures, antihypertensive medication use, and serum freezer time.
Serum TIMP-1 was positively related to LV mass and wall thickness (r=0.15, P<0.0001 and r=0.16, P<0.0001, respectively), with a 32 g higher LV mass and 2.2 mm thicker walls in the fourth compared with the first quartile of serum TIMP-1. Serum TIMP-1 was also inversely related to LV ejection fraction (r=-0.10, P=0.009), but not to LV dimension or diastolic function indices. Serum MMP-9 was only weakly related to LV wall thickness and isovolumic relaxation time (r=0.08, P=0.04 and r=-0.08, P=0.04).
In this large population-based sample, serum TIMP-1 levels were related to LV mass, wall thickness, and inversely to systolic function. This may imply that extracellular matrix remodeling is involved already in the earliest stages of the process leading to heart failure.
细胞外基质重塑是病理性左心室（LV）肥厚和心力衰竭的一个标志。这一过程受降解性基质金属蛋白酶（MMPs）及其组织抑制剂（TIMPs）的严格控制。我们推测，在出现左心室重塑迹象但尚未发生临床心力衰竭的人群中，循环中的MMP - 9和TIMP - 1水平已经发生改变。
在乌普萨拉老年人血管前瞻性研究中进行的横断面研究，该研究是一个基于社区的队列，包含891名70岁且无瓣膜疾病、心力衰竭和心肌梗死的男性和女性。
我们研究了血清MMP - 9和TIMP - 1与超声心动图左心室几何形状和功能之间的关系。所有模型均对性别、身高、动脉内收缩压和舒张压、抗高血压药物使用情况以及血清冷冻时间进行了校正。
血清TIMP - 1与左心室质量和壁厚呈正相关（分别为r = 0.15，P < 0.0001和r = 0.16，P < 0.0001），血清TIMP - 1第四四分位数组与第一四分位数组相比，左心室质量高32 g，壁厚厚2.2 mm。血清TIMP - 1也与左心室射血分数呈负相关（r = -0.10，P = 0.009），但与左心室尺寸或舒张功能指标无关。血清MMP - 9仅与左心室壁厚和等容舒张时间呈弱相关（r = 0.08，P = 0.04和r = -0.08，P = 0.04）。
在这个基于大量人群的样本中，血清TIMP - 1水平与左心室质量、壁厚相关，与收缩功能呈负相关。这可能意味着细胞外基质重塑在导致心力衰竭的过程的最早阶段就已涉及。
