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. 2011 Dec 28:11:77.
doi: 10.1186/1471-2261-11-77.

Novel association patterns of cardiac remodeling markers in patients with essential hypertension and atrial fibrillation

Andreas S Kalogeropoulos  1 , Sotirios Tsiodras, Angelos G Rigopoulos, Eleftherios A Sakadakis, Andreas Triantafyllis, Dimitrios Th Kremastinos, Ioannis Rizos
Affiliations

Novel association patterns of cardiac remodeling markers in patients with essential hypertension and atrial fibrillation

Andreas S Kalogeropoulos et al. BMC Cardiovasc Disord. .

Abstract

Background: Matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) are essential for the cardiac extracellular matrix (ECM) remodeling. We investigated differences in serum levels of these markers between patients with atrial fibrillation (AF) and sinus rhythm (SR).

Methods: Serum levels of MMP-2, MMP-3, MMP-9 and TIMP-1 were measured in 86 patients: 27 on SR without any AF history, 33 with paroxysmal and 26 with permanent AF. All subjects had essential hypertension, normal systolic function and no coronary artery disease.

Results: Patients with AF had higher MMP-2, MMP-3 and MMP-9 and lower TIMP-1 compared to SR subjects (all p < 0.001). Paroxysmal AF was associated with higher MMP-2 levels compared to permanent AF (p < 0.001). Matrix metalloproteinase-9 but not MMP-3 was higher in permanent compared to paroxysmal AF group (p < 0.001). Patients with AF had lower levels of TIMP-1 compared to those with SR while permanent AF subjects had lower TIMP-1 levels than those with paroxysmal AF (p < 0.001 for both comparisons). Lower TIMP-1 was the only independent factor associated with AF (OR: 0.259, 95%CI: 0.104-0.645, p = 0.004).

Conclusions: In hypertensives, paroxysmal AF and permanent AF differ with respect to serum MMPs. Increased MMP-2 is associated with paroxysmal, whereas increased MMP-9 with permanent AF. Additionally, lower levels of TIMP-1 had a strong association with AF incidence.

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Figures

Figure 1
Figure 1
Serum levels of MMP-9, MMP-3, MMP-2 and TIMP-1 in hypertensive patients with Sinus Rhythm (SR), paroxysmal and permanent AF.
Figure 2
Figure 2
Scatter dot diagrams, of all AF patients taken together, demonstrating direct linear correlations between: a. left atrial volume and logMMP-9; b. left atrial volume and logTIMP-1; c. left atrial volume to BSA ratio and logMMP-9; d. left atrial volume to BSA ratio and logTIMP-1.
Figure 3
Figure 3
The likelihood of AF incidence according to logTIMP-1 serum levels in patients with essential hypertension.
See this image and copyright information in PMC

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