Abstract 13869: Mitral Tissue Inhibitor of Metalloproteinase 2 Expression as a Outcome Predictor After Mitral Valve Surgery
Background: Matrix metalloproteinase plays an essential role in regulating cardiac remodeling. We previously reported an association between tissue inhibitor of metalloproteinase 2 (TIMP-2) expression and mitral valve (MV) disease. In this study we investigated the determinants and prognostic value of mitral TIMP2 after MV surgery.
Method: This retrospective study of 164 patients who had received MV surgery in a tertiary medical center in Taiwan assessed mitral TIMP2 on a semiquantitative scale (0-2) by immunohistochemical staining. The primary endpoints were the composite of death and heart failure admission.
Results: The mean age of the subjects was 50.4±13.7 years. After a mean follow-up period of 101± 59 months, primary endpoint events had occurred in 32 (19.5%) subjects. Patients with and without primary endpoint events significantly differed in terms of age (56.8±14.3 vs. 48.8±13.2 years, respectively; p = 0.003), left ventricular end-diastolic diameter (59.3±7.6 vs. 55.7±10.1 mm, respectively; p = 0.029) and left ventricular end-systolic diameter (LVESD) (39.5±8.4 vs. 35.3±7.4 mm, respectively; p=0.006) at surgery. The TIMP2 had a significant dose-dependent association with development of a primary endpoint (p = 0.002). Kaplan-Meier analysis showed that TIMP2 expression has a significant positive association with primary endpoint-free survival (log-rank test; p = 0.002). Cox regression analysis showed that independent predictors of primary endpoints were TIMP2 (hazard ratio [HR] 0.420; 95% confidence interval [CI] 0.205-0.861; p = 0.018), age (HR 1.046; 95% CI 1.015-1.078; p = 0.003) and LVESD (HR 1.061; 95% CI 1.018-1.105; p = 0.005).
Conclusion: Mitral TIMP2 expression predicts cardiovascular outcome after MV surgery.
- © 2013 by American Heart Association, Inc.