Department of Medicine and Geriatrics, Kochi Medical School, Nankoku, Japan.
Circ J. 2010 Jun;74(6):1191-6. doi: 10.1253/circj.cj-09-1013. Epub 2010 Apr 20.
The impact of matrix metalloproteinase (MMP) on left ventricular (LV) remodeling and heart failure events is unresolved in patients with hypertrophic cardiomyopathy (HCM).
Plasma levels of MMP-2, MMP-9, tissue inhibitor of metalloproteinase (TIMP)-1 and clinical findings and heart failure events were evaluated in 41 HCM patients, including 8 with LV systolic impairment. Plasma B-type natriuretic peptide (BNP) levels were also measured. MMP-2 levels in patients with severe symptoms were higher than that in those with no or mild symptoms. The levels of MMP-2 and TIMP-1 were positively related to LV end-systolic and left atrial dimensions, and inversely related to LV ejection fraction. MMP-2 levels were positively related to BNP levels (r=0.52, P=0.0009). However, MMP-9 levels were not related to echocardiographic parameters and plasma BNP levels. Six patients had complicated heart failure events during the follow-up period of 3.2+/-0.7 years. Patients with high plasma MMP-2 levels (>1,170 ng/ml) revealed a poorer prognosis than those with low MMP-2 levels.
Elevated levels of MMP-2 were related to LV remodeling and poor prognosis in patients with HCM. These results suggest that regulation of the extracellular collagen matrix might be one of the therapeutic targets in patients with HCM.
基质金属蛋白酶（MMP）对左心室（LV）重构和心力衰竭事件的影响在肥厚型心肌病（HCM）患者中尚未得到解决。
评估了 41 例 HCM 患者的 MMP-2、MMP-9、金属蛋白酶组织抑制剂（TIMP）-1 血浆水平以及临床发现和心力衰竭事件，其中 8 例患者存在 LV 收缩功能障碍。还测量了血浆 B 型利钠肽（BNP）水平。严重症状患者的 MMP-2 水平高于无症状或轻度症状患者。MMP-2 和 TIMP-1 水平与 LV 收缩末期和左心房尺寸呈正相关，与 LV 射血分数呈负相关。MMP-2 水平与 BNP 水平呈正相关（r=0.52，P=0.0009）。然而，MMP-9 水平与超声心动图参数和血浆 BNP 水平无关。6 例患者在 3.2+/-0.7 年的随访期间出现复杂的心力衰竭事件。血浆 MMP-2 水平较高（>1170ng/ml）的患者预后较差。
MMP-2 水平升高与 HCM 患者的 LV 重构和不良预后有关。这些结果表明，细胞外胶原基质的调节可能是 HCM 患者的治疗靶点之一。
