Clinical significance and dynamics of biomarkers of myocardial remodeling in patients with ST segment elevation myocardial infarction and preserved left ventricular function
T.B. Pecherina, N.V. Fedorova, A.I. German, A.G. Chernobay, T.P. Solodilova, V.N. Karetnikova, O.V. Gruzdeva, O.M. Polikutina, V.V. Kashtalap, O.L. Barbarash
Federal State Budgetary Research Institution В«Scientific-research Institute for Complex Problems of cardiovascular disease», 650002, Kemerovo, Sosnovy boul., 6
Keywords: биологические маркеры, инфаркт миокарда, сохранная функция левого желудочка, диастолическая дисфункция, biological markers, myocardial infarction, preserved left ventricular function, diastolic dysfunction
Abstract
Objective: to determine the clinical significance of markers of myocardial remodeling (NT-proBNP, galectin-3, sST2, MMP-1, 2, 3 and TIMP-1) in patients with ST segment elevation myocardial infarction and preserved left ventricular function. Materials and methods. 100 consecutive patients diagnosed with ST segment elevation myocardial infarction (STEMI) and LV ejection fraction ≥40 % were included. All patients underwent revascularization of the culprit artery. Echocardiography was performed in all the patients on days 1 day, 10-12 and in a year after hospitalization. In all the patients on admission, days 10-12 and in a year after STEMI serum concentrations of the following markers were assessed: matrix metalloproteinases-1, 2 and 3 (MMP), tissue inhibitor of matrix metalloproteinase-1 (TIMP-1), galectin-3; N-terminal brain natriuretic propeptide (NT-proBNP); soluble protein of the IL-1 receptor family (sST2). Results. The concentration of MMP-3, determined on days 10-12 of the MI, was 1.62 times higher than the values measured on the first day. While the concentration of soluble ST2 receptor, on the contrary, is almost twice as low on days 10-12 as measured on the 1st day. Also statistically significant dynamics in the period of hospitalization was determined for galectin-3 ( p = 0.0001), MMP-2 ( p = 0.0003), NT-proBNP ( p = 0.0361). Analyzing the differences in the concentrations of the markers under study, taking into account the presence / absence of signs of DD, draws attention to the fact of large median values in the group of patients with DD ( n = 38): galectin-3 at each of the observation points, NT-proBNP by the 10-12th day and in a year, MMP-1 - on the 1st and 10-12th day of observation, MMP-2 - at the annual observation stage, MMP-3 - on the 1st and 10-12th days from the MI, TIMP-1 - on the contrary, in the group of patients with DD the concentrations were lower in comparison with patients without DD ( n = 62) both on the 1st day and a year later. For sST2 no significant differences were found. Conclusions. It was determined that in the group of patients with ST segment elevation myocardial infarction and preserved LV function in the hospital period and a year later, a statistically significant dynamics of the majority of studied markers was registered, which indicates the regular processes of structural and functional remodeling of myocardium of the LV at different stages of observation. Significant differences in the levels of studied markers were determined between the groups, taking into account the presence / absence of diastolic dysfunction in patients with preserved and middle fraction of LV ejection.
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