title: Impact of metalloproteinases on left ventricular remodeling and heart failure events in patients with hypertrophic cardiomyopathy.
abstract: BACKGROUND
  The impact of matrix metalloproteinase (MMP) on left ventricular (LV) remodeling and heart failure events is unresolved in patients with hypertrophic cardiomyopathy (HCM).
  
  
  RESULTS
  Plasma levels of MMP-2, MMP-9, tissue inhibitor of metalloproteinase (TIMP)-1 and clinical findings and heart failure events were evaluated in 41 HCM patients, including 8 with LV systolic impairment. Plasma B-type natriuretic peptide (BNP) levels were also measured. MMP-2 levels in patients with severe symptoms were higher than that in those with no or mild symptoms. The levels of MMP-2 and TIMP-1 were positively related to LV end-systolic and left atrial dimensions, and inversely related to LV ejection fraction. MMP-2 levels were positively related to BNP levels (r=0.52, P=0.0009). However, MMP-9 levels were not related to echocardiographic parameters and plasma BNP levels. Six patients had complicated heart failure events during the follow-up period of 3.2+/-0.7 years. Patients with high plasma MMP-2 levels (>1,170 ng/ml) revealed a poorer prognosis than those with low MMP-2 levels.
  
  
  CONCLUSIONS
  Elevated levels of MMP-2 were related to LV remodeling and poor prognosis in patients with HCM. These results suggest that regulation of the extracellular collagen matrix might be one of the therapeutic targets in patients with HCM.
authors.affiliation: Department of Medicine and Geriatrics, Kochi Medical School, Nankoku, Japan. kitaokah@kochi-u.ac.jp
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kitaoka
authors.forename: Toru
authors.initials: T
authors.lastname: Kubo
authors.forename: Makoto
authors.initials: M
authors.lastname: Okawa
authors.forename: Kayo
authors.initials: K
authors.lastname: Hayato
authors.forename: Naohito
authors.initials: N
authors.lastname: Yamasaki
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Matsumura
authors.forename: Yoshinori L
authors.initials: YL
authors.lastname: Doi
mesh_terms: D000368:Aged; D002312:Cardiomyopathy, Hypertrophic / Q000097:blood / Q000201:enzymology*; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000201:enzymology*; D006801:Humans; D008297:Male; D020778:Matrix Metalloproteinase 2 / Q000097:blood; D020780:Matrix Metalloproteinase 9 / Q000097:blood; D045726:Metalloproteases / Q000097:blood*; D008875:Middle Aged; D011379:Prognosis; D019715:Tissue Inhibitor of Metalloproteinase-1 / Q000097:blood; D020257:Ventricular Remodeling
chemical_list: D019715:Tissue Inhibitor of Metalloproteinase-1; D045726:Metalloproteases; D020778:Matrix Metalloproteinase 2; D020780:Matrix Metalloproteinase 9