Increased matrix metalloproteinase (MMP) abundance occurs with adverse left ventricular (LV) remodeling in a number of cardiac disease states, including those induced by long-standing arrhythmias. However, whether regionally contained aberrant electrical activation of the LV, with consequent dyskinesia, alters interstitial MMP activation remained unknown. Electrical activation of the LV of pigs (n ϭ 10, 30 -35 kg) was achieved by pacing (150 beats/min) at left atrial and LV sites such that normal atrioventricular activation (60 min) was followed by regional early LV activation for 60 min within 1.5 cm of the paced site and restoration of normal atrioventricular pacing for 120 min. Regional shortening (piezoelectric crystals) and interstitial MMP activity (microdialysis with MMP fluorogenic substrate) at the LV pacing site and a remote LV site were monitored at 30-min intervals. During aberrant electrical stimulation, interstitial MMP activity at the paced site was increased (122 Ϯ 4%) compared with the remote region (100%, P Ͻ 0.05). Restoration of atrioventricular pacing after the 60-min period of aberrant electrical activation normalized segmental shortening (8.5 Ϯ 0.4%), but MMP activity remained elevated (121 Ϯ 6%, P Ͻ 0.05). This study demonstrates that despite the restoration of mechanical function, disturbances in electrical conduction, in and of itself, can cause acute increases in regional in vivo MMP activation and, therefore, contribute to myocardial remodeling. myocardium; interstitium ACUTE AS WELL AS CHRONIC ACTIVATION of matrix metalloproteinases (MMPs) within the myocardium can disrupt the integrity of the extracellular matrix (ECM) and, consequently, affect interstitial protein content, stability, and bioactive signaling pathways (9,14,19). Mechanical stimuli, such as abnormal myocardial stress and strain patterns, can also result in MMP induction (8,12,20). In this context, Garcia et al. (11) demonstrated that acute arrhythmias can disrupt electrical activation pathways and, therefore, induce alterations in the stretch/ contraction patterns of the myocardium and serve as a primary impetus for MMP activation and a potential nidus for stimuli to propagate a remodeling process. For example, previous studies (1, 22) have shown that short-duration disruption of electrical conduction induced in the atria can progress to the development of a sustained arrhythmia with associated remodeling of the myocardium. However, whether and to what degree an increase in MMP induction as a result of acute changes in electrical activation persist after the restoration of normal conduction patterns remain unknown. Therefore, the present study was designed to test the hypothesis that short-term (i.e., acute) alterations in the electrical activation of the myocardium would cause in vivo MMP activation and that the restoration of electrical conduction would normalize interstitial MMP activity.
METHODS
Instrumentation. Animals were treated and cared for in accordance with the National Institutes of Health Guide for the C...