| Synergistic effect of mitral expression of tissue inhibitor of metalloproteinase-2 with hypertension on the occurrence of mitral chordae tendinae rupture. | |
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MedLine Citation:
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PMID: 19727008 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: We previously found the association between mitral chordae tendinae ruptures (MCTR) and hypertension. Tissue inhibitor of metalloproteinase-2 (TIMP2), which expresses differently under pressure loads, could trigger a signal cascade instigating cardiac fibrosis, possibly predisposing to MCTR. We aimed to elucidate the relationship between the TIMP2 and hypertension and the effect they may have on the occurrence of MCTR. METHODS: Using a cross-sectional study in a tertiary medical center in Taiwan, we enrolled 186 patients who had received mitral valve replacements and classified them into two groups: 64 (34%) with MCTR and 122 (66%) without MCTR. Expression of mitral TIMP2 was assessed on a semiquantitative scale (grade 0-3) by immunohistochemical staining using antibodies against TIMP2. RESULTS: TIMP2 expression was significantly higher in MCTR patients (P < 0.001). Multiple logistic regression analysis showed four independent risk factors: TIMP2 [odds ratio (OR) = 1.82, 95% confidence interval (CI) = 1.18-2.81, P = 0.007], hypertension (OR = 2.40, CI = 1.08-5.34, P = 0.032), rheumatic heart disease (OR = 0.18, CI = 0.05-0.70, P = 0.014), and left ventricular end-diastolic dimension (OR = 1.10, CI = 1.05-1.15, P < 0.001). Among nonhypertensive patients, the higher expression of TIMP2 (grade 2 and 3 vs. 0 and 1) was associated with a 3.27-fold risk. However, hypertensive patients with higher TIMP2 expression had a significantly 10-fold higher risk (P < 0.001 for interaction). CONCLUSION: Mitral TIMP2 expression is higher in patients with MCTR and there is a synergistic effect of mitral TIMP2 staining with hypertension on the occurrence of MCTR. |
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Authors:
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Tsung-Hsien Lin; Sheau-Fang Yang; Chaw-Chi Chiu; Ya-Ting Lee; Ho-Ming Su; Wen-Chol Voon; Wen-Ter Lai; Sheng-Hsiung Sheu |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of hypertension Volume: 27 ISSN: 1473-5598 ISO Abbreviation: J. Hypertens. Publication Date: 2009 Oct |
Date Detail:
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Created Date: 2009-11-09 Completed Date: 2010-01-28 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8306882 Medline TA: J Hypertens Country: England |
Other Details:
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Languages: eng Pagination: 2079-85 Citation Subset: IM |
Affiliation:
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Department of Internal Medicine, Division of Cardiology, Kaohsiung Medical University Hospital, Taiwan, ROC. |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Chordae Tendineae / enzymology, pathology* Female Fibrosis Heart Rupture / epidemiology, metabolism*, pathology Humans Hypertension / epidemiology, metabolism* Logistic Models Male Middle Aged Mitral Valve / enzymology, pathology Mitral Valve Insufficiency / epidemiology, metabolism*, pathology Rheumatic Heart Disease / epidemiology Risk Factors Tissue Inhibitor of Metalloproteinase-2 / metabolism* Ventricular Dysfunction, Left / epidemiology |
| Chemical | |
Reg. No./Substance:
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127497-59-0/Tissue Inhibitor of Metalloproteinase-2 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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