on June 1, 2004
Published online before print June 1, 2004, doi: 10.1161/01.CIR.0000129318.79570.84
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Submitted on October 24, 2003
From the Framingham Heart Study (J.S., J.C.E., E.J.B., D.L., M.G.L., P.S., P.W.F.W., R.S.V.), Framingham, Mass; the National Heart, Lung, and Blood Institute (D.L.); and the Department of Preventive Medicine (E.J.B., D.L., R.S.V.), Cardiology Section (E.J.B., D.B.S., W.S.C., R.S.V.), and the Myocardial Biology Unit (D.B.S., D.A.S., W.S.C.), Boston University School of Medicine, Boston, Mass. * To whom correspondence should be addressed. E-mail: vasan{at}bu.edu.
Background--Plasma levels of matrix metalloproteinase-9 (MMP-9), a key determinant of extracellular matrix degradation, are increased in heart failure and in acute coronary syndromes. We investigated cross-sectional relations of plasma MMP-9 to vascular risk factors and echocardiographic left ventricular (LV) measurements. Methods and Results--We studied 699 Framingham Study participants (mean age, 57 years; 58% women), free of heart failure and previous myocardial infarction, who underwent routine echocardiography. We examined sex-specific distributions of LV internal dimensions (LVEDD) and wall thickness (LVWT) and sampled persons with both LVEDD and LVWT below the sex-specific median (referent, n=299), with increased LVEDD (LVEDD Conclusions--In our community-based sample, detectable plasma MMP-9 levels were associated with increased LV diastolic dimensions and increased wall thickness in men. These observations indicate that plasma MMP-9 level may be a marker for cardiac extracellular matrix degradation, a process involved in LV remodeling.
Revised on February 20, 2004
Accepted on February 25, 2004
Relations of Plasma Matrix Metalloproteinase-9 to Clinical Cardiovascular Risk Factors and Echocardiographic Left Ventricular Measures. The Framingham Heart Study
Johan Sundström MD, PhD,
90th percentile, n=204) and increased LVWT (LVWT 90th percentile, n=221) in a 3:2:2 ratio. Plasma MMP-9 was detectable in 138 persons (20%). In multivariable models, increasing heart rate (OR per SD, 1.41; 95% CI, 1.17 to 1.71) and antihypertensive treatment (OR, 1.63; 95% CI, 1.06 to 2.50) were key clinical correlates of detectable plasma MMP-9. In multivariable-adjusted models, detectable plasma MMP-9 was associated with increased LVEDD (OR, 2.84; 95% CI, 1.13 to 7.11), increased LVWT (OR, 2.54; 95% CI, 1.00 to 6.46), and higher LV mass (P=0.06) in men but not in women (OR for increased LVEDD, 1.37; 95% CI, 0.54 to 3.46; for increased LVWT, 0.99; 95% CI, 0.39 to 2.52; P=0.59 for LV mass).
Key words: heart failure • hypertrophy • metalloproteinases • remodeling • echocardiography
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