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European Heart Journal 2004 25(17):1509-1516; doi:10.1016/j.ehj.2004.05.029
Copyright © 2004 by the European Society of Cardiology.
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Clinical research

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

Johan Sundströma, Jane C. Evansa, Emelia J. Benjamina,b,c, Daniel Levya,b,e, Martin G. Larsona, Douglas B. Sawyerc,d, Deborah A. Siwikd, Wilson S. Coluccic,d, Peter W.F. Wilsona and Ramachandran S. Vasana,b,c,*

a The Framingham Study, Boston University School of Medicine, 73 Mt Wayte Ave Suite 2, Framingham, MA, USA
b Department of Preventive Medicine, Boston University School of Medicine, Boston, MA, USA
c Cardiology Section, Boston University School of Medicine, Boston, MA, USA
d Myocardial Biology Unit, Boston University School of Medicine, Boston, MA, USA
e NHLBI, USA

Received October 15, 2003; revised May 4, 2004; accepted May 26, 2004 * Corresponding author. Tel.: +1-508-935-3450; fax: +1-508-626-1262
vasan{at}bu.edu

See page 1475 for the editorial comment on this article1

Aims Tissue inhibitor of metalloproteinases-1 (TIMP-1) is a key regulator of extracellular matrix degradation. We examined relations of plasma total TIMP-1 to cardiovascular risk factors and echocardiographic left ventricular (LV) structure and function in a community-based sample.

Methods and results We studied 1069 Framingham Heart Study participants (mean age 56 years, 58% women) free of heart failure and previous myocardial infarction. Plasma TIMP-1 was higher in men compared with women, and increased with age, body mass index and total/HDL–cholesterol ratio, but decreased with alcohol intake. Plasma TIMP-1 was also directly related to smoking, diabetes and use of anti-hypertensive treatment. Adjusting for age, sex and height, plasma TIMP-1 was positively associated with LV mass, wall thickness, relative wall thickness, end-systolic diameter, and left atrial diameter and the risk of having increased LV end-diastolic diameter or increased wall thickness, and negatively correlated with fractional shortening. Additional adjustment for clinical covariates attenuated the relations of plasma TIMP-1 to most echocardiographic measures.

Conclusions In our cross-sectional investigation, plasma total TIMP-1 was related to major cardiovascular risk factors and to indices of LV hypertrophy and systolic dysfunction. This raises the possibility that cardiovascular risk factors may influence cardiovascular remodelling via extracellular matrix degradation, which may be reflected in plasma TIMP-1 levels.

Key Words: Heart failure • Left ventricular hypertrophy • Metalloproteinases • Remodelling • Echocardiography


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