Prognostic value of circulatory markers of biomechanical stress in patients after q-wave myocardial infarction

摘要

Background: Following acute myocardial infarction (MI), myocytes and the interstitium are changed immediately.Extracellular matrix reposition after MI is considered as a one of powerful integral mechanisms of cardiacremodeling that determinates individual cardiovascular risk value. Recently clinical trials have been shown thatboth early post-MI dilatation of left ventricular cavity and spherical transformation of one are tightly associatedwith poor short-term and long-term prognosis as well. Matrix metalloproteinases (MMPs) play an important andpivotal role in processes around heart architectonic disorders in subjects after acute MI. It has been clarified thatMMP-3, known as stromelysin-1, and ММP-9 can accelerate a reposition of extracellular matrix and thereby toplay a pivotal role in cardiac remodelling after acute MI. Cardiac architectonics disorders, associated withsuppression of pump function and relaxation disturbance, both neurohormonal and proinflammatory activationsmediate an genes expression coding brain-type natriuretic peptide production (BNP). Elevation of NT-pro-BNPconcentration in blood of acute MI patients was superior than contemporary score GRACE for predicting earlyand late mortality, but both markers using can increase sensitivity each other. A predispose value of circulatingNT-pro-BNP in subjects without symptomatic LV dysfunction during early post-MI period is still became aspoint of discussion. It has been proposed that ММP-3, ММP-9, and NT-pro-BNP plasma level can havedifferent prognostic value for risk of cardiovascular events after MI.