Pacing-induced cardiomyopathy: pathophysiological insights through matrix metalloproteinases

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Fozia Z Ahmed1, Rajdeep S Khattar, Amir M Zaidi

  • 1Manchester Heart Centre, Manchester Royal Infirmary, Oxford Road, Manchester, M13 9WL, UK, foziaahmed@doctors.org.uk.

Heart Failure Reviews
|July 17, 2013
PubMed

Insights

Chronic right ventricular pacing can cause heart dysfunction. Matrix metalloproteinases (MMPs) are implicated in pacing-induced cardiomyopathy (PiCMP) development, suggesting new prevention strategies.

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.

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