Early Change of Extracellular Matrix and Diastolic Parameters in Metabolic Syndrome

Abstract

BackgroundMetabolic syndrome (MS) is associated with increased cardiovascular risk. It is not clear whether myocardial changes showed in this syndrome, such as diastolic dysfunction, are due to the systemic effects of the syndrome, or to specific myocardial effects. ObjectivesCompare diastolic function, biomarkers representing extracellular matrix activity (ECM), inflammation and cardiac hemodynamic stress in patients with the MS and healthy controls. MethodsMS patients (n = 76) and healthy controls (n=30) were submitted to a clinical assessment, echocardiographic study, and measurement of plasma levels of metalloproteinase-9 (MMP9), tissue inhibitor of metalloproteinase-1 (TIMP1), ultrasensitive-reactive-C-Protein (us-CRP), insulin resistance (HOMA-IR) and natriuretic peptide (NT-proBNP). ResultsMS group showed lower E' wave (10.1 ± 3.0 cm/s vs 11.9 ± 2.6 cm/s, p = 0.005), increased A wave (63.4 ± 14.1 cm/s vs. 53.1 ± 8.9 cm/s; p < 0.001), E/E' ratio (8.0 ± 2.2 vs. 6.3 ± 1.2; p < 0.001), MMP9 (502.9 ± 237.1 ng / mL vs. 330.4±162.7 ng/mL; p < 0.001), us-CRP (p = 0.001) and HOMA-IR (p < 0.001), but no difference for TIMP1 or NT-proBNP levels. In a multivariable analysis, only MMP9 was independently associated with MS. ConclusionMS patients showed differences for echocardiographic measures of diastolic function, ECM activity, us-CRP and HOMA-IR when compared to controls. However, only MMP9 was independently associated with the MS. These findings suggest that there are early effects on ECM activity, which cannot be tracked by routine echocardiographic measures of diastolic function.

Brain Natriuretic Propeptide as a Marker of the Heart Damage in Metabolic Syndrome

“…B. et al при изучении диастолических параметров у лиц с МС было выяв-лено, что у пациентов с МС пик Е значимо ниже, чем в контрольной группе (10,1±3,0 см/с vs 11,9±2,6 см/с, p=0,005), выше пик А (10,1±3,0 см/с vs 11,9±2,6 см/с, p=0,005) и соотношение Е/Е' (8,0±2,2 vs 6,3±1,2; p<0,001) [12]. По данным Бондарь И. А. и соавт., у пациентов с СД 2 типа и АГ с ИБС была выявлена взаимосвязь NT-proBNP с параметрами, характери-зующих систолическую функцию ЛЖ (ФВ, КДР, КСР) и отсутствовала корреляция данного гормона с показателями диастолической функции [13].…”

Extracellular Matrix Turnover: a Balance between MMPs and their Inhibitors

“…The authors 1 aimed to compare diastolic function, biomarkers representing extracellular matrix activity (MMP9 and TIMP1), inflammation and cardiac hemodynamic stress in patients with the metabolic syndrome and healthy controls. We thank authors for their excellent data and valuable study but some comments may be of beneficial.…”

“…We read with great interest the article by Santos et al 1 , entitled "Early Change of Extracellular Matrix and Diastolic Parameters in Metabolic Syndrome", which was published in october of Arquivos Brasileiros de Cardiologia. The authors 1 aimed to compare diastolic function, biomarkers representing extracellular matrix activity (MMP9 and TIMP1), inflammation and cardiac hemodynamic stress in patients with the metabolic syndrome and healthy controls. We thank authors for their excellent data and valuable study but some comments may be of beneficial.…”