title: Soluble P-selectin and matrix metalloproteinase 2 levels are elevated in patients with diastolic dysfunction independent of glucose metabolism disorder or coronary artery disease.
abstract: OBJECTIVE
  The development of diastolic dysfunction (DDF) is multifactorial. Possible mechanisms include metabolic disturbances, myocardial fibrosis, chronic inflammation and endothelial dysfunction. Recognizing early stages of DDF may help to identify patients at risk of developing symptomatic DDF. Therefore, biomarkers reflecting pathophysiological changes within the myocardium were investigated in patients with DDF.
  
  
  METHODS
  Seventy-seven patients submitted for coronary angiography with stable or suspected coronary artery disease (CAD) were consecutively enrolled. Those without known diabetes mellitus (DM) underwent a standardized oral glucose tolerance test. Echocardiography for the diagnosis of DDF was performed according to the European Society of Cardiology. Matrix metalloproteinase 2 (MMP-2) and soluble P-selectin (sP-selectin) serum concentrations were analyzed using the ELISA technique.
  
  
  RESULTS
  A total of 36% of patients had DM and 74% had CAD. The prevalence of DDF was higher in patients with DM (89% versus 74%) and CAD (84% versus 53%) (P<0.05). DDF in patients with DM was more severe with a significantly lower mitral annulus velocity of 6.5 cm/s versus 7.8 cm/s (P<0.01). Patients with DDF showed significantly higher sP-selectin (140.3 mug/L versus 107.6 mug/L, P<0.05) and MMP-2 (270.5 mug/L versus 224.7 mug/L, P<0.05) levels compared with those without DDF. There was a significant correlation between sP-selectin and MMP-2 (P=0.01), independent of the diagnosis of DM or CAD.
  
  
  CONCLUSIONS
  sP-selectin as a marker for platelet hyperactivity, inflammation and endothelial dysfunction, and MMP-2 as a marker for extracellular matrix turnover were significantly elevated in patients with DDF. This elevation was independent of coexisting DM or CAD. This observation may help to identify and monitor patients with DDF.
authors.affiliation: Helios Clinics Wuppertal, Heart Center;
authors.forename: Reiner
authors.initials: R
authors.lastname: Füth
authors.forename: Wilfried
authors.initials: W
authors.lastname: Dinh
authors.forename: Werner
authors.initials: W
authors.lastname: Nickl
authors.forename: Lars
authors.initials: L
authors.lastname: Bansemir
authors.forename: Michael Coll
authors.initials: MC
authors.lastname: Barroso
authors.forename: Alexander
authors.initials: A
authors.lastname: Bufe
authors.forename: Armin
authors.initials: A
authors.lastname: Sause
authors.forename: Thomas
authors.initials: T
authors.lastname: Scheffold
authors.forename: Thomas
authors.initials: T
authors.lastname: Krahn
authors.forename: Peter
authors.initials: P
authors.lastname: Ellinghaus
authors.forename: Mark
authors.initials: M
authors.lastname: Lankisch