049 The influence of left ventricular systolic function and clinical status of ischemia on plasma levels of metalloproteinases -9 and -7 and their inhibitors in patients with coronary artery disease

To describe the enzymatic profile of plasma matrix metalloproteinases (MMP7 and MMP9) and their tissue inhibitors (TIMP1 and TIMP2) in different categories of patients (pts.) with coronary artery disease (CAD), and their relationship with clinical status, left ventricular (LV) function and remodelling. Total MMP7, active fraction of MMP9, TIMP1 and TIMP2 were determined in 68 consecutive pts with confirmed CAD (Group A, 56.6 ± 9.9 years, 75% men) and compared with a control group of 23 pts. with normal coronary arteries (Group B, 58.1 ± 10.7 years, 56.5% men). LVEF was calculated by Simpson's method. We calculated global longitudinal (L), circumferential (C) and radial (R) strain (S) and strain rate (SR) values as the average of segmental values by 2D strain analyses. The active form of MMP9 differed significantly between group A and B, as did the MMP9/TIMP1 and MMP9/TIMP2 ratios (8.78 ± 10.0 ng/ml vs 3.33 ± 4.0 ng/ml p = 0.016; 5.43 ± 3.4 v 0.85 ± 0.9, p = 0.039 and 11.60 ± 5.2 v 3.71 ± 1.0, p = 0.022, respectively). Group A included 35 pts. with acute coronary syndromes (ACS) and 33 pts. with stable angina (SA), with similar profile of LVEF and number of coronary arteries involved. The were no significant differences in MMP9, MMP9/TIMP1 and MMP/TIMP2 ratio between normal and SA group, but only between normal and ACS group (p = 0.02 for MMP9). In group A, only MMP7, TIMP1/MMP7 and TIMP2/MMP7 ratio corellated with markers of systolic function: LVEF (p<0.05 for all), and global LS (r = 0.31, r = 0.40, r = 0.23, p = 0.023, respectively, p<0.05 for all). There were no significant correlations between MMP or TIMP and global C and R-S or SR. There were no significant changes in extracellular matrix markers in pts. with chronic stable ischemia vs normals. Only active form of MMP9 and its ratio with TIMP differed significantly in ACS. Total MMP7 and its ratio with TIMP correlated with parameters of LV systolic function even in pts. with normal LVEF.