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Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
Published on: January 28, 2020
Temporal association between circulating proteolytic, inflammatory and neurohormonal markers in patients with
Ariel Finkelstein1, Yoav Michowitz, Anastasia Abashidze
1The Department of Cardiology, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, Tel Aviv, Israel.
Insights
Matrix metalloproteinase (MMP) and tissue inhibitor of metalloproteinase (TIMP) dysregulation may contribute to generalized coronary ectasia (CE). Pro B-type natriuretic peptide (proBNP) might mediate this imbalance in CE patients.
Area of Science:
- Cardiovascular Biology
- Biochemistry
- Pathophysiology
Background:
- Coronary ectasia (CE) prevalence is increasing, but its underlying mechanisms remain unclear.
- Dysregulation of matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) is hypothesized to contribute to CE.
- The association of MMPs with inflammatory and neurohormonal markers in CE is also under investigation.
Purpose of the Study:
- To investigate the role of circulating MMPs and TIMPs in the pathogenesis of coronary ectasia.
- To evaluate the association between MMPs, TIMPs, and inflammatory/neurohormonal markers in CE patients.
Main Methods:
- Serum levels of MMP-2, MMP-3, TIMP-1, pro-B-type natriuretic peptide (proBNP), and high-sensitivity C-reactive protein (hsCRP) were measured.
- Patients with generalized CE, single CE, atherosclerotic coronary disease, and normal coronary arteries were included.
- Enzyme-linked immunosorbent assay (ELISA) was used for serum level determination.
Main Results:
- Serum levels of MMP-2, MMP-3, TIMP-1, proBNP, and hsCRP did not significantly differ between the overall groups.
- MMP-3 levels were significantly lower in patients with generalized CE compared to single CE.
- A significant correlation was found between proBNP and MMP-2/TIMP-1 specifically in CE patients.
Conclusions:
- An MMP/TIMP imbalance appears to be present in generalized CE, potentially contributing to its formation.
- This imbalance may be mediated by pro-B-type natriuretic peptide (BNP).
- Further research is warranted to elucidate the precise role of MMP/TIMP dysregulation in CE.
Background:
The prevalence of coronary ectasia (CE) appears to rise in recent years. However, the pathogenetic mechanisms that underlie this entity are not understood. We hypothesized that dysregulation of circulating matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinase (TIMPs) contributes to ectasia formation. We also evaluated the association of MMP with inflammatory or the neurohormonal markers.
Methods:
We screened coronary angiographic procedures conducted in our hospital. Thirty-four patients with CEs were identified; 17 with a single ectasia and 17 with generalized ectasias. Two control groups; patients with atherosclerotic coronary disease (n=26) and patients with normal coronary arteries (n=27) were chosen randomly. Serum levels of MMP-2, MMP-3 and TIMP-1 were determined by ELISA. Pro B-type natriuretic peptide (proBNP) and high sensitivity C-reactive protein (hsCRP) serum levels were also measured.
Results:
Serum levels of MMP-2, MMP-3, TIMP-1, proBNP and hsCRP did not differ between the three groups of patients. However, subgroup analysis demonstrated that MMP-3 level is significantly lower in patients with generalized CEs compared to those with single vessel ectasia. We also found a statistically significant correlation between proBNP and MMP-2/TIMP-1 (for MMP-2: r(2)=0.3, p=0.003 and for TIMP-1 r(2)=0.42, p<0.000l). By performing subgroup analysis we found that this correlation is only demonstrated in patients with CEs. No correlation was demonstrated between hsCRP and MMPs/TIMP.
Conclusions:
These observations suggest that MMP/TIMP imbalance is present in patients with generalized CE and may contribute to ectasia formation. This imbalance could be mediated by BNP.
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