Relations of plasma total TIMP-1 levels to cardiovascular risk factors and echocardiographic measures: the Framingham Heart Study

Cezary Szmigielski

Department of Internal Medicine
Hypertension and Vascular Diseases,
The Medical University of Warsaw,
Banacha Street 1A, 02-097 Warsaw, Poland
Tel: +48 22 599 28 28
Fax: +48 22 599 18 28
E-mail address: cezary{at}amwaw.edu.pl

Malgorzata Raczkowska

Department of Internal Medicine
Hypertension and Vascular Diseases
The Medical University of Warsaw
Warsaw, Poland

Grzegorz Styczynski

Department of Internal Medicine
Hypertension and Vascular Diseases
The Medical University of Warsaw
Warsaw, Poland

Piotr Pruszczyk

Department of Internal Medicine
Hypertension and Vascular Diseases
The Medical University of Warsaw
Warsaw, Poland

Zbigniew Gaciong

Department of Internal Medicine
Hypertension and Vascular Diseases
The Medical University of Warsaw
Warsaw, Poland

Johan Sundström et al.1 presented their very interesting data linking TIMP-1 levels to cardiovascular risk factors, including left ventricular hypertrophy. As the authors mentioned, TIMP-1 levels were previously measured in a number of cardiovascular diseases, such as hypertension, coronary disease, and heart failure, but the groups studied were smaller and results were inconsistent. Plasma TIMP-1 levels seem to be more often used than other possible biochemical parameters of collagen metabolism, at least in cardiovascular patients.25 However, not only increased left ventricular mass, but also increased intima media thickness of the common carotid arteries (IMT) can serve as an independent risk factor for cardiovascular events. Increased IMT may be related to the accumulation of extracellular proteins due to altered metabolism of collagen. Comparing patients with untreated essential hypertension with healthy controls, we found not only increased IMT in the former, but also significantly elevated plasma TIMP-1 levels. Moreover, we found a significant, positive correlation between IMT and the levels of TIMP-1 in hypertensives, but not in healthy subjects.6 We think that TIMP-1 level may be a biomarker of the remodelling of the entire cardiovascular system, not only the left ventricle of the heart.

References

  1. Sundström J, Evans JC, Benjamin EJ et al. Relations of plasma total TIMP-1 levels to cardiovascular risk factors and echocardiographic measures: the Framingham Heart Study. Eur Heart J 2004;25:1509–1516.[Abstract/Free Full Text]
  2. Lindsay MM, Maxwell P, Dunn FG. TIMP-1. A marker of left ventricular diastolic dysfunction and fibrosis in hypertension. Hypertension 2002;40:136–141.[Abstract/Free Full Text]
  3. Timms PM, Wright A, Maxwell P et al. Plasma tissue inhibitor of metalloproteinase-1 levels are elevated in essential hypertension and related to left ventricular hypertrophy. Am J Hypertens 2002;15:269–272.[CrossRef][ISI][Medline]
  4. Lopez B, Gonzalez A, Varo N et al. Biochemical assessment of myocardial fibrosis in hypertensive heart disease. Hypertension 2001;38:1222–1226.[Abstract/Free Full Text]
  5. Weber KT, Brilla CG, Campbell SE et al. Pathologic hypertrophy with fibrosis: the structural basis for myocardial failure. Blood Press 1992;1:75–85.[Medline]
  6. Szmigielski C, Raczkowska M, Styczynski G, Pruszczyk P, Gaciong Z. Metabolism of collagen is altered in hypertensives with increased intima media thickness. Circulation 2003;108:iv-400.




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