Plasma profiles of matrix metalloproteinases and tissue inhibitors of the metalloproteinases predict recurrence of atrial fibrillation following cardioversion

J Cardiovasc Transl Res. 2013 Aug;6(4):528-35. doi: 10.1007/s12265-013-9471-2. Epub 2013 May 31.

Abstract

Atrial fibrosis is considered to contribute to atrial fibrillation (AF) recurrence following cardioversion. This study tested the hypothesis that circulating levels of matrix metalloproteinases (MMPs) and tissue inhibitors of MMPs (TIMPs) can predict AF recurrence postcardioversion. Precardioversion plasma samples (n = 82) were assayed for MMPs (eight types), TIMPs (all four types), N-terminus pro B-type natriuretic peptide, and high-sensitivity C-reactive protein levels. Patients were followed for AF recurrence postcardioversion. Despite 100 % restoration of sinus rhythm, 36 (44 %) reverted to AF within 3 months. Left atrial volume was increased in patients in whom AF recurred. Precardioversion MMP-9 was higher and TIMP-4 lower with AF recurrence. MMP-9, MMP-3, and TIMP-4 independently predicted AF recurrence. In multivariate analysis, combination of MMP-9, MMP-3, and TIMP-4 increased prediction of AF recurrence. Circulating levels of MMPs and TIMPs predict AF recurrence postcardioversion and may be used in a novel biomarker panel to guide AF stratification and therapy.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Atrial Fibrillation / blood
  • Atrial Fibrillation / diagnosis
  • Atrial Fibrillation / enzymology
  • Atrial Fibrillation / surgery*
  • Biomarkers / blood
  • C-Reactive Protein / metabolism
  • Chi-Square Distribution
  • Electric Countershock / adverse effects*
  • Fibrosis
  • Heart Atria / enzymology
  • Heart Atria / pathology
  • Heart Atria / surgery
  • Humans
  • Logistic Models
  • Matrix Metalloproteinases / blood*
  • Middle Aged
  • Multivariate Analysis
  • Natriuretic Peptide, Brain / blood
  • Peptide Fragments / blood
  • Predictive Value of Tests
  • Recurrence
  • Risk Factors
  • Time Factors
  • Tissue Inhibitor of Metalloproteinases / blood*
  • Treatment Outcome

Substances

  • Biomarkers
  • Peptide Fragments
  • Tissue Inhibitor of Metalloproteinases
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain
  • C-Reactive Protein
  • Matrix Metalloproteinases