Document Detail

Plasma metalloproteinase-9 and restrictive filling pattern as major predictors of outcome in patients with ischemic cardiomyopathy.
MedLine Citation:
PMID:  22939806     Owner:  NLM     Status:  In-Data-Review    
OBJECTIVE: Assessment of plasma matrix metalloproteinase-9 (MMP-9) and Doppler markers of increased left ventricular (LV) filling pressure may be added to risk stratify patients with ischemic cardiomyopathy (IC). Therefore, we aimed at investigating the value of plasma MMP-9 and restrictive filling pattern (RFP) in IC patients.
METHODS: Eighty-eight consecutive patients hospitalized for heart failure (LV ejection fraction≤40%) due to IC were enrolled. A complete M-mode and two-dimensional echo-Doppler examination were performed. Patients were defined as having RFP if they had a mitral E wave deceleration time<150ms. Plasma MMP-9 and N-terminal protype-B natriuretic peptide levels were assessed at the time of the index echocardiogram. The end point was all-cause mortality or hospitalization for worsening HF. Follow-up period was 25±17months.
RESULTS: Median value of MMP-9 was 714ng/ml. On univariate analysis, a number of measurements predicted the composite end point: NYHA class>2, RFP, MMP-9>60.5ng/ml, LV ejection fraction<27%, anemia, pulmonary pressure≥35mmHg, N-terminal protype-B natriuretic peptide>1742pg/ml, and glomerular filtration rate<60ml/min/1.73m(2). Independent variables of outcome were anemia (HR=1.9, p=0.031), and the combination of plasma MMP-9 and RFP (HR=3.2, p=0.004). On Kaplan-Meier survival curves, patients with elevated MMP-9 levels and RFP had the lowest event-free survival rate (log-rank: 29.0, p<0.0001). The net reclassification improvement showed a significant increase in the prediction model when elevated MMP-9 and RFP were added to the base model that included clinical, biochemical and echocardiographic parameters (p<0.0001).
CONCLUSION: MMP-9 levels and RFP have an incremental predictive value to risk classify IC patients.
Gani Bajraktari; Mario Miccoli; Simona Buralli; Paolo Fontanive; Shpend Elezi; Maria Rita Metelli; Angelo Baggiani; Frank Lloyd Dini
Related Documents :
8750556 - Tumour necrosis factor alpha is elevated in serum and cerebrospinal fluid in multiple s...
3754626 - Treatment of cerebrospinal fluid leaks and gram-negative bacillary meningitis with larg...
19561326 - Cerebrospinal immunoglobulin level changes and clinical response to treatment of hashim...
18000466 - Relationship between obesity, obstructive sleep apnea, and spontaneous cerebrospinal fl...
6862856 - Histopathological features of the skin in hypopituitarism and laron-type dwarfism.
25488166 - Insufficient control of heart rate in stable coronary artery disease patients in latvia.
Publication Detail:
Type:  Journal Article     Date:  2012-05-16
Journal Detail:
Title:  European journal of internal medicine     Volume:  23     ISSN:  1879-0828     ISO Abbreviation:  Eur. J. Intern. Med.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-09-03     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9003220     Medline TA:  Eur J Intern Med     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  616-20     Citation Subset:  IM    
Copyright Information:
Copyright © 2012. Published by Elsevier B.V.
Service of Cardiology, Internal Medicine Clinic, University Clinical Centre of Kosova, Prishtina, Kosovo.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  The effects of electrode misplacement on clinicians' interpretation of the standard 12-lead electroc...
Next Document:  Pacing of the interventricular septum versus the right ventricular apex: A prospective, randomized s...