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Alterations in circulating activin A, GDF‐15, TGF‐β3 and MMP‐2, ‐3, and ‐9 during one year of left ventricular reverse remodelling in patients operated for severe aortic stenosis
Author(s) -
Bjørnstad Johannes L.,
Neverdal Nils O.,
Vengen Øystein A.,
Knudsen Cathrine Wold,
Husebye Trygve,
Pepper John,
Lie Mons,
Christensen Geir,
Tønnessen Theis
Publication year - 2008
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.2008.09.010
Subject(s) - medicine , cardiology , stenosis , matrix metalloproteinase , heart failure , transforming growth factor , ventricular remodeling
Background: Patients with aortic stenosis (AS) develop left ventricular remodelling with cardiomyocyte hypertrophy and increased fibrosis. Following aortic valve replacement (AVR) reverse remodelling usually takes place. Aims: To examine circulating levels of members of the transforming growth factor (TGF) superfamily and matrix metalloproteinases (MMP), known to have important effects on hypertrophy and extracellular matrix, in patients operated for AS. Methods: Circulating levels of activin A, GDF‐15, TGF‐β3, MMP‐2, ‐3, and ‐9 were measured in twenty‐two patients undergoing AVR preoperatively, and 2 days, six months and 12 months postoperatively. Echocardiography and a six minute walking test evaluated reverse remodelling and physical performance. Results: Activin A increased at six (1081.00±98.05 pg/ml, p <0.05) and twelve months (1263.09±141.43 pg/ml, p <0.05) compared to the preoperative value (855.00±76.30 pg/ml) and correlated negatively to physical performance. The preoperative value was also increased compared to controls (639.54±63.05 pg/ml, p <0.05). GDF‐15, MMP‐3 and ‐9 were all increased at two days postoperatively ( p <0.05). MMP‐3 correlated with left ventricular end diastolic dimension ( p <0.05). MMP‐2 did not change during the study period. TGF‐β3 was only slightly reduced at six months postoperatively. Conclusion: The observed alteration in circulating levels of members of the TGF‐β superfamily and MMPs might play a role in the reverse remodelling process following AVR for AS.