Reverse ventricular remodelling after cardiac resynchronization therapy is associated with a reduction in serum tenascin-C and plasma matrix metalloproteinase-9 levels.
BACKGROUND
In heart failure patients, cardiac resynchronization therapy (CRT) leads to reverse ventricular remodelling.


OBJECTIVE
The aim of this study was to evaluate whether changes in levels of circulating biomarkers of extracellular matrix metabolism correlate with the response to CRT.


RESULTS
Clinical parameters, left ventricular (LV) volumes, and circulating levels of tenascin-C (TNC), matrix metalloproteinase-2 (MMP-2), MMP-9, and amino-terminal propeptide of brain natriuretic peptide (NT-proBNP) were assessed in 64 patients at baseline and 6 months follow-up. The majority of patients (72%) showed a >10% reduction in LV end-systolic volume at follow-up, and were classified as responders to CRT. The remaining patients were classified as non-responders. In responders, a significant decrease in circulating levels of TNC (from 60+/-40 ng/mL to 47+/-30 ng/mL, p<0.01), MMP-9 (from 55+/-30 AU to 44+/-27 AU, p<0.01), and NT-proBNP (from 2106+/-1805 pg/mL to 1132+/-1289 pg/mL, p<0.001) were observed at follow-up; MMP-2 levels were unchanged. In non-responders TNC, NT-proBNP, MMP-9 and MMP-2 levels remained unchanged.


CONCLUSIONS
At 6 months follow-up, CRT was associated with reverse LV remodelling, and a significant decrease in TNC, MMP-9, and NT-proBNP levels. This suggests an important role of ECM modulation in the process of reverse ventricular remodelling in patients responding to CRT.
Hessel
Marleen H M
MH
Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
Bleeker
Gabe B
GB
Bax
Jeroen J
JJ
Henneman
Maureen M
MM
den Adel
Brigit
B
Klok
Margreet
M
Schalij
M J
MJ
Atsma
Douwe E
DE
van der Laarse
Arnoud
A
D000368:Aged; D015415:Biomarkers; D002304:Cardiac Pacing, Artificial; D005109:Extracellular Matrix; D005260:Female; D006352:Heart Ventricles / Q000473:pathology*; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000503:physiopathology* / Q000628:therapy; D008297:Male; D020778:Matrix Metalloproteinase 2; D020780:Matrix Metalloproteinase 9 / Q000097:blood*; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain; D010446:Peptide Fragments; D011446:Prospective Studies; D019063:Tenascin / Q000097:blood*; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000473:pathology* / Q000628:therapy; D020257:Ventricular Remodeling
D015415:Biomarkers; D010446:Peptide Fragments; D019063:Tenascin; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D020778:Matrix Metalloproteinase 2; D020780:Matrix Metalloproteinase 9