110 The promoter activity of matrix metalloproteinase-3 gene is associated with left ventricular remodelling and regurgitation in Mitral Valve Prolapse patients

Purpose: To investigate the effects of rosuvastatin and benazepril on matrix metalloproteinase-2 (MMP-2), MMP-9 and leukotriene B4 (LTB4) of patients with acute myocardial infarction (AMI). Methods: Fifty-six patients with AMI were selected. They were randomly divided into control and study groups. Thirty healthy people were used in the normal group. On the basis of conventional therapy, patients in the control group were given rosuvastatin orally, while those in the study group received rosuvastatin and benazepril orally. The duration of treatment in both groups was 3 months. Serum levels of MMP-2, MMP-9 and LTB4, and incidence of left ventricular remodelling and recurrence of cardiovascular events were determined before and after treatment for both groups. Results: MMP-2, MMP-9 and LTB4 levels in serum were significantly lower for the two groups after treatment, when compared to pre-treatment values, and significantly lower in the study group (p < 0.05). Left ventricular remodelling was lower in the study group than in the control group (p < 0.05). Recurrence of cardiovascular events declined significantly in the study group, relative to control (p > 0.05). Conclusion: Rosuvastatin and benazepril significantly reduce serum levels of MMP-2, MMP-9 and LTB4 in AMI patients, and thus can potentially prevent ventricular remodelling, improve prognosis and reduce recurrence rate.

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Left ventricular remodelling patterns after MitraClip implantation in patients with severe mitral valve regurgitation: mechanistic insights and prognostic implications

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jey088 ◽

2018 ◽

Vol 20 (3) ◽

pp. 307-313 ◽

Cited By ~ 9

Author(s):

Hiske J Brouwer ◽

Marc C Den Heijer ◽

Bernard P Paelinck ◽

Philippe Debonnaire ◽

Marc Vanderheyden ◽

...

Keyword(s):

Mitral Valve ◽

Mitral Valve Regurgitation ◽

Left Ventricular ◽

Valve Regurgitation ◽

Ventricular Remodelling ◽

Left Ventricular Remodelling ◽

Prognostic Implications

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Predicting clinical outcome by indexed mitral valve tenting in functional mitral valve regurgitation

Open Heart ◽

10.1136/openhrt-2020-001483 ◽

2021 ◽

Vol 8 (1) ◽

pp. e001483

Author(s):

Maria von Stumm ◽

Florian Dudde ◽

Theresa Holst ◽

Tatjana Sequeira-Gross ◽

Jonas Pausch ◽

...

Keyword(s):

Mitral Valve ◽

Left Ventricular ◽

Functional Mitral Regurgitation ◽

Study Endpoint ◽

Primary Study ◽

Ventricular Remodelling ◽

Cardiac Events ◽

Left Ventricular Remodelling ◽

Primary Study Endpoint ◽

Annulus Diameter

ObjectivesMitral valve (MV) tenting parameters are indicators of left ventricular remodelling severity and may predict outcome in functional mitral regurgitation (FMR). We hypothesised that indexing of MV tenting area to body surface area (BSA), to mitral annulus diameter or gender-adjusted analysis of tenting parameters may improve their prognostic value.MethodsWe identified retrospectively 240 patients with consecutive FMR (mean age 68±10 years; men=135) from our institutional database who underwent isolated MV annuloplasty during a period of 7 years (2010–2016). Using preoperative two-dimensional transthoracic echocardiographic images, MV tenting parameters including tenting area, tenting height and annulus diameter were systematically assessed. Follow-up protocol consisted of chart review and structured clinical questionnaire. Primary study endpoint was the composite of death and adverse cardiac events (ie, MV reoperation, cardiac resynchronisation therapy implantation, ventricular assist device implantation or heart transplantation).ResultsBSA-indexed MV tenting area was identified as independent predictor of primary study endpoint (HR 1.9; 95% CI 1.1 to 3.5; p=0.02). After cut-off point analysis, BSA-indexed MV tenting area >1.35 cm2/m2 was significantly associated with primary study outcome (HR 2.3; 95% CI 1.3 to 4.0; p=0.003). Annulus-indexed MV tenting area showed only a tendency towards primary study endpoint prediction (HR 2.8; 95% CI 0.6 to 12.6; p=0.17). Between female and male patients, BSA-indexed MV tenting area was similar (1.42±0.4 cm2/m2 vs 1.45±0.4cm2/cm2; p=0.6) and gender was not associated with primary study outcome (HR 0.8; 95% CI 0.5 to 1.4; p=0.5).ConclusionIn our FMR cohort, BSA-indexed MV tenting area showed the strongest association with negative outcomes following isolated MV annuloplasty. Patients with BSA-indexed MV tenting area >1.35cm2/m2 could potentially benefit from additional surgical maneuvers addressing left ventricular remodelling.

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