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Updated: Jul 15, 2025
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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
Published on: July 20, 2022
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MMP-2 Associates With Incident Heart Failure and Atrial Fibrillation: The ARIC Study
Leo F Buckley1, Ali M Agha2, Pranav Dorbala3
1Department of Pharmacy Services (L.F.B.), Brigham and Women's Hospital, Boston, MA.
Circulation. Heart Failure
|September 27, 2023
Summary
Higher levels of matrix metalloproteinase-2 (MMP-2) are linked to increased risk of heart failure (HF) and atrial fibrillation (AF). Atrial fibrillation mediates the association between MMP-2 and HF with preserved ejection fraction.
Area of Science:
- Cardiovascular Medicine
- Biochemistry
- Epidemiology
Background:
- Matrix metalloproteinase-2 (MMP-2) plays a role in extracellular matrix regulation.
- MMP-2 may be implicated in the pathophysiology of heart failure (HF), atrial fibrillation (AF), and coronary heart disease (CHD).
Purpose of the Study:
- To investigate the association between plasma MMP-2 levels and the risk of incident HF, HF with preserved ejection fraction (HFpEF), HF with reduced ejection fraction (HFrEF), AF, and CHD.
- To explore the mediating role of AF and CHD in the MMP-2 and HF association.
- To examine the relationship between MMP-2 levels and cardiac structure and function.
Main Methods:
- Analysis of 4693 Atherosclerosis Risk in Communities (ARIC) study participants without prevalent HF.
- Utilized multivariable Cox proportional hazard models to assess associations of plasma MMP-2 with incident cardiovascular events.
- Employed multivariable linear regression to evaluate links between MMP-2 and cardiac structure/function measures.
Main Results:
- The highest quartile of MMP-2 was associated with increased risk of overall incident HF, HFpEF, HFrEF, and incident AF.
- No significant association was observed between MMP-2 and incident CHD.
- Higher MMP-2 levels correlated with adverse left ventricular and left atrial structural and functional parameters.
Conclusions:
- Elevated plasma MMP-2 levels are associated with diastolic dysfunction, left atrial dysfunction, and a higher risk of incident HF and AF.
- Atrial fibrillation acts as a mediator in the relationship between MMP-2 and the risk of HFpEF.
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