title: Plasma TIMP-4 predicts left ventricular remodeling after acute myocardial infarction.
abstract: BACKGROUND
  Alterations in the balance between matrix metalloproteinases and their endogenous tissue inhibitors (TIMPs) are associated with left ventricular (LV) remodeling after acute myocardial infarction (AMI). No relationships have been identified between TIMPs and serial postinfarction change in LV function.
  
  
  RESULTS
  Plasma concentrations of TIMP-1, -2, -4 were measured at baseline (mean 46 h) and at 24 weeks in 100 patients (age 58.9 ± 12 years, 77% male) admitted with AMI and LV dysfunction, with cardiac magnetic resonance imaging at each time point. TIMP-1 concentration was reduced, whereas TIMP-2 and -4 concentrations were elevated at baseline compared with a reference control population. TIMP-1 decreased and TIMP-2 increased significantly over time; there was an incremental trend in TIMP-4 concentration. Baseline TIMP-4 correlated with change in LV end-systolic volume index (∆LVESVI; r = 0.24; P = .023) and change in LV end-diastolic volume index (∆LVEDVI; r = 0.25; P = .015). ∆TIMP-4 also correlated with ∆LVESVI and with ∆LVEDVI, as did ∆TIMP-2. On multivariable analysis, baseline TIMP-4 concentration was an independent predictor of ∆LVESVI.
  
  
  CONCLUSIONS
  Plasma TIMP-4 concentration, measured early after AMI, may assist in the prediction of LV remodeling and therefore in the assessment of prognosis. Further study of the role of the TIMPs in the pathophysiology of postinfarction remodeling is warranted.
authors.affiliation: Cardiology Department, Western Infirmary, Glasgow, Scotland, UK. robinweir75@hotmail.com
authors.forename: Robin A P
authors.initials: RA
authors.lastname: Weir
authors.forename: Suzanne
authors.initials: S
authors.lastname: Clements
authors.forename: Tracey
authors.initials: T
authors.lastname: Steedman
authors.forename: Henry J
authors.initials: HJ
authors.lastname: Dargie
authors.forename: John J V
authors.initials: JJ
authors.lastname: McMurray
authors.forename: Iain B
authors.initials: IB
authors.lastname: Squire
authors.forename: Leong L
authors.initials: LL
authors.lastname: Ng
mesh_terms: D000368:Aged; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000503:physiopathology*; D011237:Predictive Value of Tests; D013599:Systole; D019715:Tissue Inhibitor of Metalloproteinase-1 / Q000097:blood; D019716:Tissue Inhibitor of Metalloproteinase-2 / Q000097:blood; D019714:Tissue Inhibitor of Metalloproteinases / Q000097:blood*; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000503:physiopathology; D020257:Ventricular Remodeling; D000097792:Tissue Inhibitor of Metalloproteinase-4
chemical_list: D019715:Tissue Inhibitor of Metalloproteinase-1; D019716:Tissue Inhibitor of Metalloproteinase-2; D019714:Tissue Inhibitor of Metalloproteinases; D000097792:Tissue Inhibitor of Metalloproteinase-4; C560822:TIMP1 protein, human; C560823:TIMP2 protein, human