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Release of matrix metalloproteinases following alcohol septal ablation in hypertrophic obstructive cardiomyopathy

William S. Bradham, Jr, PhD^*, Himali Gunasinghe, BS^*, Jennifer R. Holder, BS^*, Marlina Multani, MS^*, Donna Killip, RN^*, Marianne Anderson, RN, Denise Meyer, RN, William H. Spencer, III, MD, FACC^*, Guillermo Torre-Amione, MD, FACC and Francis G. Spinale, MD, PhD, FACC^*,*

^* Medical University of South Carolina, Charleston, South Carolina, USA
Baylor College of Medicine, Houston, Texas, USA

View larger version (19K): [in a new window]   Figure 1 (Top) The percent change in plasma total creatine kinase (CK) concentrations following alcohol injection into the septal perforator artery in patients with hypertrophic obstructive cardiomyopathy. Peak plasma CK levels occurred at 10 to 20 h post-injection. (Bottom) The percent change in CK MB1 isoform plasma concentrations following alcohol injection. A significant increase in CK-MB1 plasma levels was detected at 4 h and increased until 24 h following alcohol injection. *p < 0.05 vs. time 0; baseline values.

View larger version (20K): [in a new window]   Figure 2 (Top) A small but significant change in matrix metalloproteinase (MMP)-2 plasma levels from baseline was observed at 4 h following alcohol injection. (Bottom) A significant increase in plasma MMP-9 levels occurred following alcohol injection and appeared to plateau for up to 50 h following injection. *p < 0.05 vs. time 0; baseline values.

View larger version (21K): [in a new window]   Figure 3 (Top) Plasma matrix metalloproteinase (MMP)-8 levels increased in a time-dependent manner up to 24 h following alcohol injection of the septal perforator artery in patients with hypertrophic obstructive cardiomyopathy and plateaued for longer periods following alcohol injection. (Bottom) A fall in plasma MMP-13 levels was detected early following alcohol injection and was significant at 24 h. *p < 0.05 vs. time 0; baseline values.

View larger version (21K): [in a new window]   Figure 4 (Top) Plasma tissue inhibitor of matrix metalloproteinase (TIMP)-1 levels did not change immediately following alcohol injection, but tended to rise at later time points; however, this did not reach statistical significance (p = 0.15). (Bottom) The ratio of plasma matrix metalloproteinase (MMP)-9/TIMP-1 levels was computed for each patient and plotted as a change from baseline values. A significant increase in this ratio occurred by 6 h following alcohol injection. *p > 0.15 vs. time 0; baseline values.

View larger version (18K): [in a new window]   Figure 5 The area under the plasma concentration-time curve (AUC) was computed for each patient (n = 51) with respect to plasma creatine kinase MB1 fraction and matrix metalloproteinase (MMP)-9 levels. A significant linear relationship was observed between these two parameters.