Pacing-induced cardiomyopathy: pathophysiological insights through matrix metalloproteinases

Area of Science:

• Cardiology
• Biochemistry

Background:

• Pacing-induced ventricular dysfunction and cardiomyopathy (PiCMP) are known complications of chronic right ventricular pacing.
• Myocardial perfusion and sympathetic innervation changes contribute to pacing-induced heart disease, but other mechanisms are likely involved.

Purpose of the Study:

• To review the clinical epidemiology of pacing-induced ventricular dysfunction.
• To explore the role of matrix metalloproteinases (MMPs) in the development of PiCMP using insights from animal models.
• To discuss potential pacing strategies for preventing pacing-induced ventricular dysfunction.

Main Methods:

• Literature review of clinical epidemiology of pacing-induced ventricular dysfunction.
• Analysis of data from animal models to understand MMP expression and function in PiCMP.
• Exploration of preventative pacing strategies.

Main Results:

• Matrix metalloproteinases (MMPs) are key in extracellular matrix degradation and left ventricular remodeling in heart failure.
• While MMP roles in other cardiomyopathies are defined, their specific involvement in PiCMP is not well-reported.
• Animal models offer insights into how altered MMP expression and function contribute to PiCMP.

Conclusions:

• Matrix metalloproteinases (MMPs) are likely involved in the pathophysiology of pacing-induced cardiomyopathy (PiCMP).
• Further research into MMPs in PiCMP could lead to novel therapeutic and preventative strategies.
• Optimizing pacing strategies may mitigate the risk of developing pacing-induced ventricular dysfunction.