Department of Cardiology, Wroclaw Medical University, Wroclaw, Poland.
Department of Drugs Form Technology, Wroclaw Medical University, Wroclaw, Poland.
Kidney Blood Press Res. 2021;46(6):749-757. doi: 10.1159/000519594. Epub 2021 Nov 19.
Under physiological conditions, the myocardial extracellular matrix (ECM) is maintained by matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs). However, changes in the balance between MMPs and TIMPs can lead to pathological remodeling of the ECM, which contributes to cardiovascular and kidney diseases. The aim of our study was to assess levels of MMPs and TIMP-2 in patients with myocarditis and their relationship to renal function.
Forty five patients with myocarditis who underwent CMR were included, comprising 11 with concurrent chronic kidney disease (CKD). Blood samples were obtained to assess serum levels of MMP-2, MMP-3, MMP-9, and TIMP-2.
Serum MMP-2, MMP-3, and TIMP-2 levels negatively correlated with the ejection fraction in patients with myocarditis, while MMP-3 levels correlated with longitudinal deformation (p < 0.05). Serum MMP-2, MMP-3, and TIMP-2 levels also negatively correlated with renal function, as assessed by the estimated glomerular filtration rate (eGFR) (p < 0.05). Patients with myocarditis and concurrent CKD had higher levels of MMP-2 and TIMP-2 than those without kidney damage.
(1) We demonstrated that MMP-2, MMP-3, and TIMP-2 concentrations were related to left-ventricular ejection fraction, and MMP-3 levels correlated with longitudinal deformation, indicating MMPs play an important role in the post-inflammatory remodeling of the myocardium. (2) A negative correlation between the eGFR and MMP-2, MMP-3, and TIMP-2 and a positive correlation between creatinine and MMP-3 levels indicate the role of MMPs and TIMP-2 in renal dysfunction.
在生理条件下，心肌细胞外基质（ECM）由基质金属蛋白酶（MMPs）和金属蛋白酶组织抑制剂（TIMPs）维持。然而，MMPs 和 TIMPs 之间平衡的变化可导致 ECM 的病理性重塑，这有助于心血管和肾脏疾病的发生。本研究旨在评估心肌炎患者 MMPs 和 TIMP-2 的水平及其与肾功能的关系。
共纳入 45 例接受 CMR 的心肌炎患者，其中 11 例合并慢性肾脏病（CKD）。采集血样以评估血清 MMP-2、MMP-3、MMP-9 和 TIMP-2 水平。
心肌炎患者血清 MMP-2、MMP-3 和 TIMP-2 水平与射血分数呈负相关，而 MMP-3 水平与纵向应变呈正相关（p < 0.05）。血清 MMP-2、MMP-3 和 TIMP-2 水平也与肾小球滤过率（eGFR）评估的肾功能呈负相关（p < 0.05）。合并 CKD 的心肌炎患者的 MMP-2 和 TIMP-2 水平高于无肾损伤患者。
（1）我们表明 MMP-2、MMP-3 和 TIMP-2 浓度与左心室射血分数相关，MMP-3 水平与纵向应变相关，表明 MMPs 在心肌炎症后重塑中发挥重要作用。（2）eGFR 与 MMP-2、MMP-3 和 TIMP-2 呈负相关，与 MMP-3 水平呈正相关，表明 MMPs 和 TIMP-2 在肾功能障碍中的作用。
