Circulating tissue inhibitor of matrix metalloproteinase-1 is associated with aldosterone-induced diastolic dysfunction. Issue 9 (September 2015)

• Record Type: Journal Article
• Authors: Hung, Chi-Sheng; Chou, Chia-Hung; Wu, Xue-Ming; Chang, Yi-Yao; Wu, Vin-Cent; Chen, Ying-Hsien; Chang, Yuan-Shian; Tsai, Yao-Chou; Su, Ming-Jai; Ho, Yi-Lwun; Chen, Ming-Fong; Wu, Kwan-Dun; Lin, Yen-Hung
• Is Part Of: Journal of hypertension. Volume 33:Issue 9(2015:Sep.)
• Publication Date: 2015-09
• Subjects: diastolic function -- left ventricular hypertrophy -- primary aldosteronism -- TIMP-1; Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/HJH.0000000000000619
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: To test if collagen markers are associated with aldosterone-induced diastolic dysfunction. Background: Although primary aldosteronism is associated with more prominent cardiac remodeling and diastolic dysfunction, the reversibility of diastolic function is unclear. In addition, there is no known biomarker associated with aldosterone-induced diastolic dysfunction. Methods: We enrolled 27 patients with aldosterone-producing adenoma (APA) preparing for adrenalectomy, and 27 patients with essential hypertension prospectively from October 2006 to March 2010 at a tertiary referral center. Plasma matrix metalloproteinase-2 (MMP-2) and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) were measured, and echocardiography including tissue Doppler images was performed in both groups and 1 year after receiving adrenalectomy in the APA group. Results: The baseline plasma TIMP-1 level (88.4 ± 38.7 vs. 63.6 ± 32.5 ng/ml; P = 0.014), left ventricular mass index (LVMI), and E / E ' ratio (11.5 ± 2.9 vs. 9.0 ± 2.1; P < 0.001) were significantly higher in the APA group. The baseline plasma TIMP-1 level significantly correlated with the E / E ' ratio, LVMI, interventricular septum, and left atrial diameter. The plasma MMP-2 level did not correlate with the left ventricular structure parameters, except for interventricular septum thickness. After adrenalectomy, LVMI and E / E ' ratio improved significantly. The postadrenalectomy plasma TIMP-1 levels, but not MMP-2 levels, also decreased. The change of plasma TIMP-1 levels was negatively associated with the postadrenalectomy E / E ' ratio after adjustment for age, sex, BMI, and mean blood pressure ( β -coefficient = − 3.6, P = 0.004). Conclusion: Excess of aldosterone induces cardiac diastolic dysfunction, which is reversible by adrenalectomy. TIMP-1 is associated with the aldosterone-induced diastolic dysfunction.