August 20, 1999Circulation Research324 citationsOpen Access

Matrix Metalloproteinase Inhibition During the Development of Congestive Heart Failure

FSFrancis G. Spinale MCMytsi L. Coker SKStephen R. Krombach

Structured PICO

Does matrix metalloproteinase inhibition with PD166793 limit left ventricular dilation and remodeling in a pig model of pacing-induced congestive heart failure?

Population

Pigs subjected to rapid pacing (240 bpm) for 3 weeks to induce congestive heart failure (n=33 total: 12 CHF, 10 CHF/MMPi, 11 control)

Intervention

Matrix metalloproteinase inhibition (MMPi) with PD166793 (20 mg/kg per day) concomitant with rapid pacing for 3 weeks

Comparator

CHF-only (rapid pacing without MMPi) and unpaced controls

Outcome

Left ventricular size and function (fractional shortening, end-diastolic dimension) during the progression of CHFsurrogate

Chronic matrix metalloproteinase inhibition limited left ventricular dilation and reduced wall stress in a pig model of pacing-induced heart failure, suggesting MMP activity directly contributes to myocardial remodeling.

Abstract

The development of congestive heart failure (CHF) is associated with left ventricle (LV) dilation and myocardial remodeling. The matrix metalloproteinases (MMPs) play a significant role in extracellular remodeling, and recent studies have demonstrated increased MMP expression and activity with CHF. Whether increased MMP activity directly contributes to the LV remodeling with CHF remains unknown. Accordingly, this study examined the effects of chronic MMP inhibition (MMPi) on LV size and function during the progression of CHF. Pigs were assigned to the following groups: (1) CHF, rapid pacing for 3 weeks at 240 bpm (n=12); (2) CHF/MMPi, rapid pacing and concomitant MMPi (PD166793, 20 mg/kg per day n=10), and (3) control (n=11). With pacing CHF, LV fractional shortening was reduced (19+/-1 versus 45+/-1%), and end-diastolic dimension increased (5.67+/-0.11 versus 3.55+/-0.05 cm), compared with baseline values (P<0.05). In the CHF/MMPi group, LV endocardial shortening increased (25+/-2%) and the end-diastolic dimension was reduced (4.92+/-0.17 cm) compared with CHF-only values (P<0.05). LV midwall shortening was reduced to a comparable degree in the CHF-only and CHF/MMPi groups. LV peak wall stress increased 3-fold with pacing CHF compared with controls and was significantly reduced in the CHF/MMPi group. LV myocardial stiffness was unchanged with CHF but was increased in the CHF/MMPi group. LV myocyte length was increased with pacing CHF compared with controls (180+/-3 versus 125+/-4 microm, P<0.05) and was reduced in the CHF/MMPi group (169+/-4 microm, P<0.05). Basal-state myocyte shortening velocity was reduced with pacing CHF compared with controls (33+/-2 versus 66+/-1 microm/s, P<0.05) and was unchanged in the CHF/MMPi group (31+/-2 microm/s). Using an ex vivo assay system, myocardial MMP activity was increased with pacing CHF and was reduced with chronic MMPi. In summary, concomitant MMPi with developing CHF limited LV dilation and reduced wall stress. These results suggest that increased myocardial MMP activity contributes to LV myocardial remodeling in developing CHF.

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