© 2007 European Society Of Cardiology
Reverse ventricular remodelling after cardiac resynchronization therapy is associated with a reduction in serum tenascin-C and plasma matrix metalloproteinase-9 levels
Department of Cardiology, Leiden University Medical Center Leiden, The Netherlands
* Corresponding author. Department of Cardiology, Leiden University Medical Center Albinusdreef 2, 2333 ZA, Leiden, The Netherlands. Tel.: +31 715262020; fax: +31 71 5266809. E-mail address: D.E.Atsma{at}lumc.nl (D.E. Atsma).
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Abstract |
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Background: In heart failure patients, cardiac resynchronization therapy (CRT) leads to reverse ventricular remodelling.
Aim: The aim of this study was to evaluate whether changes in levels of circulating biomarkers of extracellular matrix metabolism correlate with the response to CRT.
Methods and results: Clinical parameters, left ventricular (LV) volumes, and circulating levels of tenascin-C (TNC), matrix metalloproteinase-2 (MMP-2), MMP-9, and amino-terminal propeptide of brain natriuretic peptide (NT-proBNP) were assessed in 64 patients at baseline and 6 months follow-up. The majority of patients (72%) showed a >10% reduction in LV end-systolic volume at follow-up, and were classified as responders to CRT. The remaining patients were classified as non-responders. In responders, a significant decrease in circulating levels of TNC (from 60±40ng/mL to 47±30ng/mL, p<0.01), MMP-9 (from 55±30 AU to 44±27 AU, p<0.01), and NT-proBNP (from 2106±1805pg/mL to 1132±1289pg/mL, p<0.001) were observed at follow-up; MMP-2 levels were unchanged. In non-responders TNC, NT-proBNP, MMP-9 and MMP-2 levels remained unchanged.
Conclusion: At 6months follow-up, CRT was associated with reverse LV remodelling, and a significant decrease in TNC, MMP-9, and NT-proBNP levels. This suggests an important role of ECM modulation in the process of reverse ventricular remodelling in patients responding to CRT.
Key Words: Cardiac resynchronization therapy • Left ventricular remodelling • Extracellular matrix • Tenascin-C • Matrix metalloproteinases • Brain natriuretic peptide
Received February 27, 2007; Revised June 14, 2007; Accepted July 12, 2007
This study was supported by the Netherlands Heart Foundation (Grant nr 2001.B124 and 2002B109).
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