Predictive Utility of the Changes in Matrix Metalloproteinase-2 in the Early Phase for Left Ventricular Reverse Remodeling After an Acute Myocardial Infarction

Background-The relationship between the serum levels of matrix metalloproteinase (MMP) and tissue inhibitors of MMP (TIMP) and left ventricular (LV) reverse remodeling (LV-RR) after an acute myocardial infarction (AMI) has not been sufficiently examined. Methods and Results-In 25 patients with successful reperfusion after an AMI and 15 normal control subjects, the serum MMP-2 and TIMP-2 levels were measured on days 1, 2, 3, and 7 and at 1 and 6 months after the AMI onset. LV-RR was defined as a >15% decrease in the LV end-systolic volume index at 6 months after the AMI. The MMP-2 level on day 1 and TIMP-2 levels throughout the study period were comparable between the patients with and without LV-RR. The MMP-2 on day 7 (P<0.05) and the changes in the MMP-2 from day 1 to day 7 (Delta MMP-2; P<0.01) were lower in patients with than in those without LV-RR. The Delta MMP-2 was strongly correlated with the changes in the LV volume and ejection fraction from 1 month to 6 months after the AMI. The Delta MMP-2 value of <- 158.5 ng/mL predicted LV-RR with a high accuracy (91.7% sensitivity and 76.9% specificity; area under the curve=0.82). Conclusions-Changes in MMP-2 are associated with LV-RR after an AMI. The DMMP-2 might be a useful predictor of subsequent LV-RR.