title: MMP-9 in atrial remodeling in patients with atrial fibrillation.
abstract: BACKGROUND
  Atrial fibrillation (AF) is the most common arrhythmia and is associated with significant morbidity and mortality. The impact of matrix metalloproteinases (MMPs) on structural atrial remodeling and sustainment of AF in patients with persistent and permanent AF is unresolved.
  
  
  OBJECTIVE
  The aim was to evaluate MMP-9 and its tissue inhibitor-1 (TIMP-1) as markers of atrial remodeling in patients with persistent AF (PAF) who underwent electrical cardioversion (ECV) and in patients with permanent AF (continuous AF, CAF).
  
  
  METHODS
  Plasma levels of MMP-9 and TIMP-1, clinical findings, and echocardiographic parameters were evaluated in 39 patients with AF and in 14 controls with sinus rhythm.
  
  
  RESULTS
  The concentrations of MMP-9 were significantly higher in patients with PAF and CAF compared to controls. There was a significant increase of MMP-9 after ECV in the persistent AF group. The values of TIMP-1 were not significantly different between the groups. In patients with AF, MMP-9 levels were positively related to posterior wall thickness of the LV (r=0.356, P=0.049) and body mass index (r=0.367, P=0.046).
  
  
  CONCLUSIONS
  Elevated levels of MMP-9 were related to the occurrence and maintenance of AF. This suggests that MMP-9 can be a marker of atrial remodeling in patients with AF. Regulation of the extracellular collagen matrix might be a potential therapeutic target in AF.
authors: Department of Cardiosurgery, Medical University of Białystok, ul. M. Skłodowskiej-Cure 24a, 15-276, Białystok, Poland. Electronic address: janka.lewkowicz@wp.pl.
authors: J
authors: J
authors: Lewkowicz
authors: Department of Cardiology, Medical University of Białystok, Białystok, Poland.
authors: M
authors: M
authors: Knapp
authors: Department of Monitored Pharmacotherapy, Medical University of Białystok, Białystok, Poland.
authors: A
authors: A
authors: Tankiewicz-Kwedlo
authors: Department of Cardiology, Medical University of Białystok, Białystok, Poland.
authors: R
authors: R
authors: Sawicki
authors: Department of Cardiology, Medical University of Białystok, Białystok, Poland.
authors: M
authors: M
authors: Kamińska
authors: Department of Cardiology, Medical University of Białystok, Białystok, Poland.
authors: E
authors: E
authors: Waszkiewicz
authors: Department of Cardiology, Medical University of Białystok, Białystok, Poland.
authors: W J
authors: WJ
authors: Musiał
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D064752:Atrial Remodeling / Q000502:physiology*; D015415:Biomarkers / Q000097:blood; D002908:Chronic Disease; D015150:Echocardiography, Doppler; D004554:Electric Countershock; D005260:Female; D006801:Humans; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000097:blood*; D008875:Middle Aged; D019715:Tissue Inhibitor of Metalloproteinase-1 / Q000097:blood
chemical_list: D015415:Biomarkers; C560822:TIMP1 protein, human; D019715:Tissue Inhibitor of Metalloproteinase-1; D020780:Matrix Metalloproteinase 9
keywords: Atrial fibrillation; Atrial remodeling; Fibrillation atriale; Inhibiteurs tissulaires des métalloprotéinases; Matrix metalloproteinases; Métalloprotéinases matricielles; Remodelage des oreillettes; Tissue inhibitors of metalloproteinases