August 10, 2007; doi:10.1152/ajpheart.00490.2007.-Vagal nerve stimulation has been suggested to ameliorate left ventricular (LV) remodeling in heart failure. However, it is not known whether and to what degree vagal nerve stimulation affects matrix metalloproteinase (MMP) and tissue inhibitor of MMP (TIMP) in myocardium, which are known to play crucial roles in LV remodeling. We therefore investigated the effects of electrical stimulation of efferent vagal nerve on myocardial expression and activation of MMPs and TIMPs in a rabbit model of myocardial ischemia-reperfusion (I/R) injury. Anesthetized rabbits were subjected to 60 min of left coronary artery occlusion and 180 min of reperfusion with (I/R-VS, n ϭ 8) or without vagal nerve stimulation (I/R, n ϭ 7). Rabbits not subjected to coronary occlusion with (VS, n ϭ 7) or without vagal stimulation (sham, n ϭ 7) were used as controls. Total MMP-9 protein increased significantly after left coronary artery occlusion in I/R-VS and I/R to a similar degree compared with VS and sham values. Endogenous active MMP-9 protein level was significantly lower in I/R-VS compared with I/R. TIMP-1 mRNA expression was significantly increased in I/R-VS compared with the I/R, VS, and sham groups. TIMP-1 protein was significantly increased in I/R-VS and VS compared with the I/R and sham groups. Cardiac microdialysis technique demonstrated that topical perfusion of acetylcholine increased dialysate TIMP-1 protein level, which was suppressed by coperfusion of atropine. Immunohistochemistry demonstrated a strong expression of TIMP-1 protein in cardiomyocytes around the dialysis probe used to perfuse acetylcholine. In conclusion, in a rabbit model of myocardial I/R injury, vagal nerve stimulation induced TIMP-1 expression in cardiomyocytes and reduced active MMP-9. myocardial remodeling; matrix metalloproteinase; acetylcholine LEFT VENTRICULAR (LV) myocardial remodeling that occurs after myocardial infarction (MI) leads to progressive LV dilation and eventually pump dysfunction (33,40). In addition to the loss of contractile cardiomyocytes, pathological degradation and reconstitution of extracellular matrix significantly contribute to the progression of LV remodeling, where matrix metalloproteinase (MMP) and its intrinsic inhibitor, tissue inhibitor of MMP (TIMP), play crucial roles (37,43).A previous study using genetically engineered mice demonstrated that target deletion of the MMP-9 gene prevented LV rupture and ameliorated LV remodeling after MI (10). The positive results of MMP inhibition on LV remodeling in animal models led to the proposal to use MMP inhibitors as a potential therapy for patients at risk for the development of heart failure after MI (27, 32). However, recent clinical results from the Prevention of Myocardial Infarction Early Remodeling (PREMIER) trial failed to demonstrate a beneficial effect of MMP inhibition on LV remodeling after MI (16). This indicates the importance of further understanding the in vivo regulatory mechanisms of MMPs to understand and benefic...