Relationship of myocardial fibrosis markers with cardiac structural and functional parameters in patients with post-myocardial
Authors: Sharafutdinova R , Ruzov VI , Razin VA , Gimaev RH , Nizamova LT 
Published: July 2021

Funding Acknowledgements

Type of funding sources: None.

Background. In recent years much attention has been paid to cardiac remodelling processes. Many studies provide convincing evidence for the role of aldosterone and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) in the processes of structural changes in the heart and vessels, which is of particular importance in cardiovascular remodeling in patients with hypertension, acute myocardial infarction, postinfarction cardiosclerosis and chronic heart failure.

Aim of the study. To investigate the association of myocardial fibrosis markers (TIMP-1 and aldosterone) with cardiac structural and functional parameters.

Methods and materials. We examined 40 patients with an average age of 56.4 ± 4.8 years who had had myocardial infarction more than 1 year before (mean 2.2 ± 0.8 years before). Plasma aldosterone concentration was determined using enzyme immunoassay using a DRG (Germany) EIA-4128 reagent kit. The reference values are 40-310 pg/ml. Tissue inhibitor of matrix metalloproteinase-1 concentrations were measured using DSL kits (USA). The reference values were 92-116 ng/ml. All patients underwent echocardiography to assess the structural and functional parameters of the heart. Correlation analysis with Pearson or Spearman correlation coefficient calculation was used to determine the relationships between quantitative parameters. Differences were considered statistically significant if the probability of their absolutely random nature did not exceed 5% (p &lt; 0.05).

Results. During the study, TIMP-1 concentration had a direct statistically significant medium correlation with LV end-diastolic size (r = 0.39, p = 0.012). The analysis also revealed significant correlations of TIMP-1 concentration with LV end-diastolic size (r = 0.33, p = 0.037), with LV end-systolic volume (r = 0.41, p = 0.009), with LV myocardial mass (r = 0.48, p = 0.008), with LV ejection fraction (r=-0.36, p = 0.024). No statistically significant correlations were found with other structural and functional left ventricular indices during the study. Statistical correlation analysis of the relationship between plasma concentration of aldosterone and structural-functional parameters of the left ventricle (according to the results of echocardiography), statistically significant correlations with ejection fraction (r = 0.39, p = 0.035), LV myocardial mass (r = 0.60, p = 0.001), LV myocardial mass index (r = 0.51, p = 0.004), LV interventricular septal thickness (r = 0.45, p = 0.007) were found. No statistically significant correlations with plasma aldosterone concentration were found with the other left ventricular structural and functional indices during the study.

Conclusions. The concentrations of aldosterone and tissue inhibitor of matrix metalloproteinase-1 have links with many structural and functional parameters of the heart, which confirms their importance in the structural rearrangement (remodelling) of the cardiovascular system in patients after myocardial infarction.