Association between serum matrix metalloproteinase-12/angiotensin II profile and left ventricular hypertrophy in patients with heart failure

Abstract

Introduction. Matrix metalloproteinases (MMPs) are important target genes for angiotensin II (AII), which subsequently alters MMP expression in extracellular matrix (ECM) and lead to remodeling process. Objective. To investigate whether an association between serum levels of MMP-12, AII and left ventricular hypertrophy exists in patients with heart failure with mid-range ejection fraction (HFmrEF) and arterial hypertension (AH). Material and methods. 56 patients with HFmrEF and AH were examined, mean age 65.62±9.69 years, and 22 age and sex-matched healthy subjects, mean age 56.4±5.53 years. 41 patients had hypertension-mediated organ damage and 15 did not. Patients were divided in two subgroups: subjects with left ventricular hypertrophy (n=32), (HFmrEF+LVH), and subjects without left ventricular hypertrophy (n=24), (HFmrEF-LVH). ELISA was used for measuring AII and MMP-12. Results: Serum MMP-12 levels were statistically significant lower in patients, than in controls: 0.0033 ng/mL (0.0022 ÷ 0.0071) vs. 0.0075 ng/mL (0.0068 ÷ 0.016) (KW=7.37; p=0.006). MMP-12 showed correlation with grade of AH (r=0.28; p=0.03). Patients with HFmrEF+LVH showed statistically significant higher levels of AII: 8.533 pg/mL (1.477÷13.009) than HFmrEF-LVH 1.333 pg/mL (0.477÷6.932) and healthy controls 1.539 pg/mL (0.274÷5.218); (KW=3.48; p=0.04). AII correlated with stage of AH (r=0.47; p=0.001). MMP-12/AII ratio was significantly higher in patients with HFmrEF+LVH than in HFmrEF-LVH 3.867 vs. 0.0025 (p<0.001). Conclusions. Our data suggest an association between serum MMP-12 levels, AII and grade and stage of AH. Determination of serum MMP-12/Angiotensin II profile may be a useful method for monitoring of development and progression of left ventricular hypertrophy.

Keywords

• arterial hypertension
• heart failure
• left ventricular hypertrophy
• extracellular matrix