Metalloproteinase in myocardial adaptation and maladaptation

Ventricular remodeling is a compensatory response that comprises the processes of apoptosis, muscle cell hypertrophy, and rearrangement of the extracellular matrix fibers connecting the muscles. These processes are associated with transformation of endothelium and/or fibroblasts to myofibroblasts. Neutral matrix metalloproteinases, membrane type matrix metalloproteinases, and disintegrin metalloproteinase play a significant role in these processes. The cell-extracellular matrix connections are important in maintaining and synchronizing muscle function. However, a complete extracellular matrix-cell disconnect leads to a decrease in muscle cell strength, apoptosis, and hypertrophy.