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原发性高血压伴心房颤动患者心脏重构标志物的新关联模式。

Novel association patterns of cardiac remodeling markers in patients with essential hypertension and atrial fibrillation.

机构信息

Department of Cardiology, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK.

出版信息

BMC Cardiovasc Disord. 2011 Dec 28;11:77. doi: 10.1186/1471-2261-11-77.

Abstract

BACKGROUND

Matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) are essential for the cardiac extracellular matrix (ECM) remodeling. We investigated differences in serum levels of these markers between patients with atrial fibrillation (AF) and sinus rhythm (SR).

METHODS

Serum levels of MMP-2, MMP-3, MMP-9 and TIMP-1 were measured in 86 patients: 27 on SR without any AF history, 33 with paroxysmal and 26 with permanent AF. All subjects had essential hypertension, normal systolic function and no coronary artery disease.

RESULTS

Patients with AF had higher MMP-2, MMP-3 and MMP-9 and lower TIMP-1 compared to SR subjects (all p < 0.001). Paroxysmal AF was associated with higher MMP-2 levels compared to permanent AF (p < 0.001). Matrix metalloproteinase-9 but not MMP-3 was higher in permanent compared to paroxysmal AF group (p < 0.001). Patients with AF had lower levels of TIMP-1 compared to those with SR while permanent AF subjects had lower TIMP-1 levels than those with paroxysmal AF (p < 0.001 for both comparisons). Lower TIMP-1 was the only independent factor associated with AF (OR: 0.259, 95%CI: 0.104-0.645, p = 0.004).

CONCLUSIONS

In hypertensives, paroxysmal AF and permanent AF differ with respect to serum MMPs. Increased MMP-2 is associated with paroxysmal, whereas increased MMP-9 with permanent AF. Additionally, lower levels of TIMP-1 had a strong association with AF incidence.

摘要

背景

基质金属蛋白酶(MMPs)及其组织抑制剂(TIMPs)对于心脏细胞外基质(ECM)的重塑至关重要。我们研究了在心房颤动(AF)和窦性节律(SR)患者之间这些标志物的血清水平差异。

方法

在 86 名患者中测量了 MMP-2、MMP-3、MMP-9 和 TIMP-1 的血清水平:27 名处于 SR 且无任何 AF 病史,33 名患有阵发性 AF,26 名患有永久性 AF。所有患者均患有原发性高血压、正常收缩功能且无冠心病。

结果

与 SR 患者相比,AF 患者的 MMP-2、MMP-3 和 MMP-9 水平更高,TIMP-1 水平更低(均 p < 0.001)。与永久性 AF 相比,阵发性 AF 患者的 MMP-2 水平更高(p < 0.001)。与阵发性 AF 相比,永久性 AF 患者的 MMP-9 水平更高(p < 0.001)。与 SR 患者相比,AF 患者的 TIMP-1 水平更低,而与阵发性 AF 相比,永久性 AF 患者的 TIMP-1 水平更低(两种比较均 p < 0.001)。TIMP-1 水平较低是与 AF 相关的唯一独立因素(OR:0.259,95%CI:0.104-0.645,p = 0.004)。

结论

在高血压患者中,阵发性 AF 和永久性 AF 之间在血清 MMPs 方面存在差异。MMP-2 与阵发性 AF 相关,而 MMP-9 与永久性 AF 相关。此外,TIMP-1 水平较低与 AF 发生率有很强的相关性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/edad/3276440/fd82423bf86d/1471-2261-11-77-1.jpg

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