Plasma levels of metalloproteinases-9 and -2 in the acute and subacute phases of type A and type B aortic dissection

Sangiorgi, Giuseppe; Trimarchi, Santi; Mauriello, Alessandro; Righini, Paolo; Bossone, Eduardo; Suzuki, Toru; Rampoldi, Vincenzo; Eagle, Kim A.

doi:10.2459/01.jcm.0000223251.26988.c5

Cited by 64 publications

(50 citation statements)

References 29 publications

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“…The increase in proteolytic activity that may be responsible for AAD is not necessarily reflected in TIMP expression [19]. Our findings suggest that TIMP-2 was expressed at a low level and MMP-2 at a high level, compatible with the view that the former change favors matrix degradation.…”

Section: Discussionsupporting

confidence: 67%

“…Reportedly, increased MMP-9 and MMP-2 expression in macrophages was observed at the site of the intimal tear in 6 patients with atherosclerosis related dissections [12,18]. Several clinical studies have shown an increase in MMP-9 levels in the acute and subacute phase of both type A and B aortic dissection [19,20]. A catabolic action by MMP-9 on elastin proteins may result in weakening of the mechanical properties of the aorta, predisposing it to expansion and/or rupture [21].…”

Section: Discussionmentioning

confidence: 99%

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Prognostic Value of Tissue Inhibitor of Metalloproteinase in Acute Aortic Dissection

Inagaki¹

2012

TOATHERTJ

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Abstract:Background: Increases in levels of matrix metalloproteinase (MMP) and tissue inhibitor of matrix metalloproteinase (TIMP) occur in acute aortic dissection (AAD); however, their association with prognosis in AAD remains largely unknown. We studied the use of MMP and TIMP in predicting long-term outcomes in medically controlled AAD patients.Methods: A total of 82 patients were enrolled (15 Stanford Type A and 67 type B, age 65.1±13.3). AAD was diagnosed by enhanced CT, with serial imaging studies during follow-up. Blood tests for MMP-2, MMP-9, TIMP-1, and TIMP-2 were performed within a week after symptom onset.Results: A poor outcome due to death or aortic surgical repair occurred in 17 patients, classified as an unfavorable group. The remaining 65 patients were classified into a favorable group. By multivariate analysis maximum dissection diameter (MDD), TIMP-1, and TIMP-2 were significantly associated with an unfavorable outcome (P < 0.001, P < 0.001, and P = 0.038, respectively). The ratio of TIMP-1 to TIMP-2 (cut-off value > 3.34) had significant predictive power (sensitivity 88.2%, specificity 80.0%). Patients with MDD 46.8 mm and a TIMP-1/TIMP-2 ratio 3.34 had a significantly poorer outcome (log rank P < 0.0001). Similarly, in Cox regression analysis AAD patients with MDD 46.8 mm and a TIMP-1/TIMP-2 ratio 3.34 had the highest risk for an unfavorable outcome (P < 0.001, hazard ratio 45.6, 95% confidence interval 5.96 to 348.42). Conclusion:In AAD a higher TIMP-1/TIMP-2 ratio was significantly associated with an increased risk of death or surgical repair.

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Section: Discussionsupporting

confidence: 67%

Section: Discussionmentioning

confidence: 99%

Prognostic Value of Tissue Inhibitor of Metalloproteinase in Acute Aortic Dissection

Inagaki¹

2012

TOATHERTJ

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“…Further confirming our results, the expression of MMP-12 has been reported within aortic specimens [9,10] both in humans and in mice [11], and it has been specifically related to the pathogenesis of aneurysms occurring both in ascending and in abdominal aortas [12,13]. This is different from what occurs with MMP-2 and MMP-9, which are released by several immune cells and have been related to matrix remodeling also in atherosclerotic plaque [14,15,16,17]. …”

mentioning

confidence: 44%

“…In particular, the unbalance between MMP-2 and MMP-9/TIMP-1 and TIMP-2 has been extensively reported, with aneurysms and dissections occurring both in thoracic and abdominal aortas [13,14,15,16,17,18]. Moreover, the 4 human TIMPs (1-4) are released by a wide spectrum of circulating and tissue cells [7] and show a considerable overlap in their ability to target different MMPs, so that MMP-2, MMP-9, and MMP-12 share the same TIMP-1 [7,18,19], although some differences in the affinity of specific inhibitor-protease pairs do occur [20,21].…”

mentioning

confidence: 99%

MMP-12 and Macrophage Activation in Acute Aortic Dissection

Porto

Cifani²,

Proietta³

et al. 2014

Cardiology

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“…Destruction of elastic fibers was also significantly inhibited by transfection of chimeric decoy oligodeoxynucleotide in both hypertensive and normotensive rats [32]. Sangiorgi et al [33] also observed increased MMP-9 in patients with type A or B aortic dissection.…”

Section: Acute Aortic Syndromementioning

confidence: 84%

Cardiac surgery and hypertension: a dangerous association that must be well known

Yuan¹,

Hua²

2011

Rev Bras Cir Cardiovasc

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It is well-known that hypertension is a very common disease, and severe cerebrovascular accidents might occur if the blood pressure is not properly controlled. However, conditions associated with uncontrolled hypertension may be overlooked, and may become critical and eventually require a surgical intervention on an urgent basis. Coronary artery disease, acute aortic syndrome, congenital and valvular heart disease, and arrhythmias are under this topic of discussion. Of them, coronary artery disease including myocardial infarction and especially postinfarction myocardial rupture, and aortic dissection are major critical situations that physicians may encounter in clinical practice. The role that hypertension plays in these conditions can be complex, including hemodynamic, electrophysiological and biomolecular factors, where the latter may prevail in the current era. Coronary artery disease may be associated with a reduced nitric oxide synthesis. Transforming growth factor and matrix metalloproteinases have been observed in relation to aortic syndrome. Wnt, p38 and JNK signaling pathway may be involved in the development of ventricular hypertrophy responsible for cardiac arrythmias. Various gene phynotypes may present in different congenital heart defects. This article is to present these conditions, and to Cardiac surgery and hypertension: a dangerous association that must be well knownCirurgia cardíaca e hipertensão: uma associação perigosa que deve ser bem conhecida Resumo É sabido que a hipertensão é uma doença muito comum, e que os acidentes cerebrovasculares graves podem ocorrer se a pressão sanguínea não for apropriadamente controlada. Contudo, as condições associadas à hipertensão não controlada podem ser negligenciadas, e tornarem-se críticas, necessitando, eventualmente, uma intervenção cirúrgica urgente. Doença coronariana, síndrome aórtica aguda, cardiopatias congênitas, valvopatias e arritmias são sob este tópico de discussão. Dentre eles, a doença corornariana, inclusive o infarto do miocárdio e especialmente a ruptura cardíaca pós-infarto e a dissecção aórtica, são as situações críticas principais que os médicos podem encontrar na prática clínica. O papel que a hipertensão desempenha nessas condições pode ser complexo, incluindo fatores further discuss the possible etiologies and the potential treatment strategies so as to highlight the relevance at a prognostic level.Descriptors: Cardiac Surgical Procedures. Heart Diseases. Hypertension. YUAN, SM & JING, H -Cardiac surgery and hypertension: a dangerous association that must be well knownRev Bras Cir Cardiovasc 2011;26(2):273-81 vascular tissue associated with increased endocrine and local paracrine effects; 2) the impact of the common risk factors, such as high blood pressure, that exaggerate and accelerate atherosclerotic process; and 3) hemodynamic factors, which may destabilize vascular lesions and precipitate acute events [3].A modest short-term reduction in blood pressure confers a reduction in coronary artery disease events of abou...

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Plasma levels of metalloproteinases-9 and -2 in the acute and subacute phases of type A and type B aortic dissection

Cited by 64 publications

References 29 publications

Prognostic Value of Tissue Inhibitor of Metalloproteinase in Acute Aortic Dissection

Prognostic Value of Tissue Inhibitor of Metalloproteinase in Acute Aortic Dissection

MMP-12 and Macrophage Activation in Acute Aortic Dissection

Cardiac surgery and hypertension: a dangerous association that must be well known

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