Metalloproteinases-2 and -9 predict left ventricular remodeling after myocardial infarction
Metalloproteinases-2 and -9 predict left ventricular remodeling after myocardial infarction
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DOI：
10.5935/abc.20130049
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发表时间：
2013-04-01
影响因子：
2.6
通讯作者：
Zornoff, Leonardo A. M.
中科院分区：
文献类型：
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作者：
Cogni, Ana Lucia;Farah, Elaine;Zornoff, Leonardo A. M.
背景：血清金属蛋白酶（MMP）在心肌梗死（MI）后的作用尚不清楚。目的：本研究的目的是评估血清MMP-2和-9作为前路心肌梗死后6个月心室重构预测因子的作用。方法：我们前瞻性地招募了首次前路心肌梗死后的患者，在心肌梗死后12至72小时检测MMP活性，并在住院期间和6个月后进行超声心动图检查。结果：纳入29例患者；62%表现为心室重构。根据肌酸磷酸激酶（CPK）峰值（p = 0.037），表现出重构的患者有更高的梗死面积，更高的院内充血性心力衰竭患病率（p = 0.004），以及更低的射血分数（EF） （p = 0.007）。心室重构患者血清无活性MMP-9水平显著降低（p = 0.007），活性MMP-2水平显著升高（p = 0.011）。在多变量logistic回归模型中，经年龄、CPK峰值、EF和心力衰竭患病率调整后，血清MMP-2和-9水平仍与重塑相关（p分别= 0.033和0.044）。结论：较高的血清无活性MMP-9水平与左心室容量的保存有关，而较高的血清活性MMP-2水平是心肌梗死后6个月重构的预测因子。
Background: The role of serum metalloproteinases (MMP) after myocardial infarction (MI) is unknown.Objective: The aim of this study was to evaluate the role of serum MMP-2 and -9 as predictors of ventricular remodeling six months after anterior MI.Methods: We prospectively enrolled patients after their first anterior MI. MMP activity was assayed 12 to 72 hours after the MI. An echocardiogram was performed during the hospitalization and six months later.Results: We included 29 patients; 62% exhibited ventricular remodeling. The patients who exhibited remodeling had higher infarct size based on creatine phosphokinase (CPK) peak values (p = 0.037), higher prevalence of in-hospital congestive heart failure (p = 0.004), and decreased ejection fraction (EF) (p = 0.007). The patients with ventricular remodeling had significantly lower serum levels of inactive MMP-9 (p = 0.007) and significantly higher levels of the active form of MMP-2 (p = 0.011). In a multivariate logistic regression model, adjusted by age, CPK peak, EF and prevalence of heart failure, MMP-2 and -9 serum levels remained associated with remodeling (p = 0.033 and 0.044, respectively).Conclusion: Higher serum levels of inactive MMP-9 were associated with the preservation of left ventricular volumes, and higher serum levels of the active form of MMP-2 were a predictor of remodeling 6 months after MI.