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Correlation between serum matrix metalloproteinase and myocardial fibrosis in heart failure patients with reduced ejection fraction: A retrospective analysis [Anatol J Cardiol]
Anatol J Cardiol. 2020; 24(5): 303-308 | DOI: 10.14744/AnatolJCardiol.2020.54937  

Correlation between serum matrix metalloproteinase and myocardial fibrosis in heart failure patients with reduced ejection fraction: A retrospective analysis

Ömer Çelik, Ahmet Anıl Şahin, Serdar Sarıkaya, Begüm Uygur
Department of Cardiology, University of Health Sciences, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital; İstanbul-Turkey

Objective: A strong correlation exists between myocardial fibrosis and heart failure (HF). Myocardial fibrosis can be detected by cardiac magnetic resonance (CMR), which is a crucial noninvasive imaging method with high specificity and sensitivity. Matrix metalloproteinases (MMPs) are primary proteases responsible for the degradation of extracellular matrix (ECM) components, and they play a vital role in maintaining the balance between anabolism and catabolism of ECM. This study aims to investigate the correlation between cardiac fibrosis detected on CMR and serum MMP-9 levels in patients with HF.
Methods: We enrolled 53 patients (age: ≥18 years) with left ventricular ejection fraction (LVEF) ≤40%, who received CMR because of various indications. All patients were divided into two groups-with cardiac fibrosis (n=32) and without cardiac fibrosis (n=21)-detected by CMR with late-Gadolinium. Both groups were then compared according to MMP-9 levels.
Results: MMP-9 levels were significantly higher in patients with cardiac fibrosis than those without fibrosis (p<0.01). A correlation was determined between the diffusiveness of fibrosis and serum MMP-9 levels. Besides, a statistically significant correlation was determined between MMP-9 measurements and the number of segments with fibrosis (p<0.05). In the group with cardiac fibrosis, LVEF measurements by CMR were significantly lower (p<0.01), with left ventricular end-diastolic volume (LVEDV) and left ventricular end-systolic volume (LVESV) measurements significantly higher (p<0.01), than the other group. Furthermore, we found a statistically significant correlation between MMP-9 levels and LVEDV and LVESV.
Conclusion: MMP-9 levels correlate with cardiac remodeling in patients with HF and could be useful in predicting left ventricular fibrosis. In clinical practice, the use of serum MMP-9 could provide early consideration of therapies for structural and functional pathology of the heart in patients with HF.

Keywords: myocardial fibrosis, cardiac magnetic resonance, heart failure, matrix metalloproteinase


Ömer Çelik, Ahmet Anıl Şahin, Serdar Sarıkaya, Begüm Uygur. Correlation between serum matrix metalloproteinase and myocardial fibrosis in heart failure patients with reduced ejection fraction: A retrospective analysis. Anatol J Cardiol. 2020; 24(5): 303-308

Corresponding Author: Ömer Çelik, Türkiye


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