IMR Press / FBL / Volume 12 / Issue 4 / DOI: 10.2741/2157

Frontiers in Bioscience-Landmark (FBL) is published by IMR Press from Volume 26 Issue 5 (2021). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on as a courtesy and upon agreement with Frontiers in Bioscience.

Myocardial extracellular matrix remodeling in ischemic heart failure
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1 Cardiac Technology Centre and Kolling Institute, University of Sydney at Royal North Shore Hospital, St Leonards (Sydney) NSW, Australia
2 Sutton Arthritis Research Laboratory, University of Sydney at Royal North Shore Hospital, St Leonards (Sydney) NSW, Australia
Front. Biosci. (Landmark Ed) 2007, 12(4), 1410–1419;
Published: 1 January 2007

Left ventricular (LV) remodeling is a process whereby structural alterations attempt to compensate altered hemodynamic load. In the chronic setting this process becomes maladaptive, self-sustaining and is associated with worsened survival. The extracellular matrix (ECM) of the heart, once believed an inert scaffold for cardiomyocytes, is now known to play an important role in LV remodeling. The enzyme system primarily responsible for ECM turnover is the matrix metalloproteinases (MMPs), and these enzymes are robustly altered in cardiovascular pathologies, including myocardial infarction (MI) and ischemic heart failure. A cause-and-effect relationship has been established between MMPs and LV remodeling post MI, as MMP inhibition prevents LV dilation and preserves cardiac function in animal models of infarction. In spite of this, initial clinical experience with MMP inhibition post MI has been disappointing. This review examines the structural and functional roles of the myocardial ECM, the evidence for MMP involvement in LV remodeling, and recent investigations into MMPs as prognostic markers and therapeutic targets.

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