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Predictive value of matrix metalloprotease 9 on surgical outcomes after pericardiectomy
Likui Fang1, Wenfeng Yu1, Guocan Yu1
1Department of Thoracic Surgery, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China.
Background:
The effects of matrix metalloproteases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) expressions on the patients with constrictive pericarditis undergoing pericardiectomy remain unclear. This study explored the associations of MMPs and TIMPs expressions with postoperative outcomes in these patients.
Methods:
Pericardial specimens were obtained during pericardiectomy from the patients with constrictive pericarditis. The levels of MMP1, MMP2, MMP9 and TIMP1 in pericardium were analyzed by quantitative real-time polymerase chain reaction. The enrolled patients were divided into two groups according to the optimal cutoff value of gene expression predicting postoperative complications. Postoperative outcomes were compared between the two groups. Binary logistic regression analysis was performed to determine the degree of contribution of gene expression on postoperative outcomes.
Results:
A total of 22 patients and their pericardial specimens were included. The level of MMP9 was significantly associated with postoperative complications and the optimal cutoff value predicting postoperative complications was 3.67. The patients with low level of MMP9 (< 3.67) had lower incidence of postoperative complications (P = 0.002), shorter postoperative intensive care unit (P = 0.040) and hospital stay (P = 0.043) in comparison to those with high level of MMP9 (≥ 3.67). Binary logistic regression analysis showed that high level of MMP9 increased the risk of postoperative complications (OR 27.096, 95% CI 1.166-629.886, P = 0.040).
Conclusions:
High level of MMP9 in the pericardium was associated with poor postoperative outcomes and was the independent risk factor of postoperative complications. The level of MMP9 could be used as a potential marker for prediction of surgical outcomes.
Insights
High levels of matrix metalloproteinase-9 (MMP9) in pericardial tissue correlate with increased postoperative complications in constrictive pericarditis patients. Lower MMP9 levels predict better surgical outcomes and shorter hospital stays.
Area of Science:
- Cardiovascular Surgery
- Molecular Biology
- Oncology
Background:
- Constrictive pericarditis requires surgical pericardiectomy.
- The role of matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) in surgical outcomes is not well understood.
- This study investigates MMP and TIMP expression in relation to outcomes after pericardiectomy.
Purpose of the Study:
- To explore the association between MMPs and TIMPs expression in pericardial tissue and postoperative outcomes in patients undergoing pericardiectomy for constrictive pericarditis.
- To identify potential biomarkers for predicting surgical success.
Main Methods:
- Pericardial specimens were collected from 22 constrictive pericarditis patients during pericardiectomy.
- Quantitative real-time PCR was used to analyze MMP1, MMP2, MMP9, and TIMP1 levels.
- Patients were grouped based on MMP9 expression levels to compare postoperative complications, ICU stay, and hospital duration.
- Binary logistic regression identified predictors of postoperative outcomes.
Main Results:
- Elevated MMP9 levels (≥3.67) were significantly associated with increased postoperative complications (P=0.002).
- Patients with low MMP9 (<3.67) experienced fewer complications and shorter ICU (P=0.040) and hospital stays (P=0.043).
- High MMP9 levels were an independent risk factor for postoperative complications (OR 27.096, P=0.040).
Conclusions:
- High pericardial MMP9 expression is linked to adverse postoperative outcomes in patients with constrictive pericarditis.
- MMP9 serves as a potential predictive biomarker for surgical outcomes in these patients.
- Targeting MMP9 may offer therapeutic avenues to improve surgical results.
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