Circulating TIMP-1 differed between patients and controls (P=0.006) and negatively correlated with early mitral annular velocity in hypertensive (r=-0.544) and diabetic (r=-0.341) patients.
Cross-Sectional (n=120)
Does circulating TIMP-1 correlate with echocardiographic markers of diastolic dysfunction in patients with type 2 diabetes and hypertension?
Circulating TIMP-1 levels correlate negatively with early mitral annular velocity (e'), suggesting it may serve as a biomarker for myocardial fibrosis and diastolic dysfunction in patients with hypertension and diabetes.
Effect estimate: Spearman r = -0.544 (hypertensives), r = -0.341 (diabetics)
p-value: p=0.001 (hypertensives), 0.011 (diabetics)
BACKGROUND: Tissue inhibitor of metalloproteinase-1 (TIMP-1) is associated with increased fibrosis of the extracellular matrix (ECM). Myocardial stiffness is a feature of diastolic dysfunction. We assessed circulating TIMP-1 as a marker of diastolic dysfunction in patients with type 2 diabetes mellitus (DM) and hypertension, who were compared with healthy controls. METHODS: We recruited 54 patients (43 males; mean age 68 +/- 5 years) with treated type 2 DM (i.e. controlled glycaemia, hypertension, hyperlipidaemia), 35 (30 males; 69 +/- 8 years) treated nondiabetic hypertensives, and 31 healthy controls (18 males; 66 +/- 5 years). Circulating TIMP-1 was measured by ELISA. Using transthoracic echocardiography, the early (E) diastolic mitral inflow velocity was measured with pulse wave Doppler, and the early mitral annular velocity (e'), a recognized index of diastolic relaxation, was measured with tissue Doppler. The E/A ratio was also calculated and isovolumic relaxation time measured. RESULTS: Mean e' levels differed significantly between controls, diabetics and hypertensives (P < 0.0001). Circulating TIMP-1 was significantly different between patients and controls (P = 0.006), but there was no statistically significant difference between the DM and hypertension group. In both groups, only e' was negatively correlated with TIMP-1 levels, with a stronger correlation among the hypertensive patients (Spearman r = -0.544, P = 0.001) when compared with the diabetic group (r = -0.341, P = 0.011). CONCLUSION: Diastolic relaxation is impaired in diabetes and hypertensive patients. The relationship between TIMP-1 and e' may reflect increased myocardial fibrosis and consequent diastolic dysfunction, which may be more prominent in hypertension.
Tayebjee et al. (Sat,) conducted a cross-sectional in Type 2 diabetes mellitus and hypertension (n=120). Circulating TIMP-1 vs. Healthy controls was evaluated on Correlation between circulating TIMP-1 and early mitral annular velocity (e') (Spearman r = -0.544 (hypertensives), r = -0.341 (diabetics), p=0.001 (hypertensives), 0.011 (diabetics)). Circulating TIMP-1 differed between patients and controls (P=0.006) and negatively correlated with early mitral annular velocity in hypertensive (r=-0.544) and diabetic (r=-0.341) patients.