Key result
Elevated MMP-9 and TIMP-1 in HCM show no difference across stable, progressive, or AF groups.
Why the study?
To assess the relationship between fibrosis markers and structural and functional parameters in patients with various types of hypertrophic cardiomyopathy.
Do levels of fibrosis markers (MMP-9 and TIMP-1) correlate with myocardial remodeling and disease course in patients with hypertrophic cardiomyopathy?
Observational (n=49)
Do levels of fibrosis markers (MMP-9 and TIMP-1) correlate with myocardial remodeling and disease course in patients with hypertrophic cardiomyopathy?
p-value: p=0.59
High activity of matrix metalloproteinases and their tissue inhibitors reflects enhanced fibrosis and myocardial remodeling in HCM, correlating with left atrial volume.
MMP-9 may mark atrial remodeling in HCM; hypothesis-generating and should not yet change practice.
Aim. To assess the relationship between fibrosis markers and structural and functional parameters in patients with various types of hypertrophic cardiomyopathy (HCM). Material and methods. This prospective comparative non-randomized study included 49 patients with HCM. Patients were divided into 3 groups according to the disease course: group 1 — stable course (n=12; men, 8 (67%), mean age ‒ 41±12 years); group 2 — progressive course (n=26; men, men, 16 (61%). mean age — 57±11 years); group 3 — patients with atrial fibrillation (AF) (n=11; men, 4 (36%), mean age — 63±6 years). Patients underwent standard clinical and paraclinical investigations. The levels of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinases-1 (TIMP-1) were determined in all patients using enzyme-linked immunosorbent assay in blood serum. Results. In all patients with HCM, elevated levels of MMP-9 and TIMP-1 are noted compared to the reference values. In group 1, the MMP-9 level [Me (Q1; Q3)] was 226 (201;271) ng/ml; TIMP-1 — 410 (267;488) ng/ml; in group 2, the MMP-9 level was 236 (187;285) ng/ml; TIMP-1 — 421 (321;499) ng/ml. In the course with AF, the MMP-9 level was 260 (228;296) ng/ml, while TIMP-1 — 381,5 (305;466) ng/ml; no significant difference was revealed (p=0,59; p=0,90, respectively). A correlation was found between age and MMP-9 levels, as well as between MMP-9 levels and left atrial volume (p=0,034; p=0,035, respectively). Conclusion. The high activity of matrix metalloproteinases and their tissue inhibitors reflects enhanced fibrosis and myocardial remodeling in HCM, which is especially characteristic of patients with AF.
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Bogatyreva et al. (2022) conducted an observational in hypertrophic cardiomyopathy (HCM) (n=49). Hypertrophic cardiomyopathy disease course (stable, progressive, atrial fibrillation) vs. Reference values was evaluated on Levels of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinases-1 (TIMP-1) (p=0.59). Elevated levels of MMP-9 and TIMP-1 were found in all patients with hypertrophic cardiomyopathy, with no significant differences across stable, progressive, or atrial fibrillation groups (p=0.59 and p=0.90).
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