The role of matrix metalloproteinases in left ventricular remodeling in patients with ST-segment elevation myocardial infarction

Aim. To assess the role of matrix metalloproteinases (MMPs) in pathological remodeling of the left ventricular myocardium in patients with ST-segment elevation myocardial infarction (STEMI).

Materials and Methods. We recruited 175 consecutive patients with STEMI (average age 61.3 (range 47-89) years, 116 (66.3%) males and 59 (33.7%) females). Control group was represented by 87 healthy volunteers (average age 59 (range 43-68) years). Serum levels of MMP-1, MMP-3, MMP-9, N-terminal pro В-type natriuretic peptide (NT-proBNP), and pro-atrial natriuretic peptide (proANP) were measured at the time of admission and on the 12^th day from the onset using enzyme-linked immunosorbent assay. Echocardiography was performed in all patients at the same time points to assess cardiac fibrosis. Groups were stratified according to the extent of left ventricular dysfunction.

Results. Levels of MMP-1 were 1.7-fold and 2.7-fold higher on the 1^st and 12^th day after STEMI onset, respectively, as compared to healthy individuals. Similar trend was found for NT-proBNP and proANP (2.3-fold and 1.5-fold increase in serum NT-proBNP and 3.5/1.8-fold increase in proANP in patients with STEMI in comparison with healthy blood donors on the 1^st and 12^th day after STEMI onset). Concentrations of all MMPs onthe 12^th day 1.1-1.6-fold exceeded those at the admission; however, the reverse was the case for NT-proBNP and proANP. Patients with systolic dysfunction (< 55% left ventricular ejection fraction, n = 128) and diastolic dysfunction (E/A < 1, n = 112) had higher concentrations of all indicated markers, yet statistically significant differences were determined only for MMP-3, NT-proBNP, and proANP in patients with systolic dysfunction and for MMP-9 in those with diastolic dysfunction both on the 1^st and 12^th day after STEMI onset.

Conclusion. Patients with systolic dysfunction have significantly higher levels of serum MMP-3, NT-proBNP, and proANP on the 1^st and 12^th day after STEMI as compared to those without while patients with diastolic dysfunction are characterized by higher MMP-9 level at the same time points.

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