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Reverse ventricular remodelling after cardiac resynchronization therapy is associated with a reduction in serum tenascin‐C and plasma matrix metalloproteinase‐9 levels
Author(s) -
Hessel Marleen H.M.,
Bleeker Gabe B.,
Bax Jeroen J.,
Henneman Maureen M.,
Adel Brigit,
Klok Margreet,
Schalij M.J.,
Atsma Douwe E.,
Laarse Arnoud
Publication year - 2007
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/j.ejheart.2007.07.007
Subject(s) - medicine , tenascin c , heart failure , cardiac resynchronization therapy , cardiology , extracellular matrix , brain natriuretic peptide , matrix metalloproteinase , ventricular remodeling , matrix metalloproteinase 3 , ejection fraction , immunohistochemistry , biology , microbiology and biotechnology
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.