EXTRACELLULAR MATRIX DISTURBANCES IN ACUTE MYOCARDIAL...

EXTRACELLULAR MATRIX DISTURBANCES IN ACUTE MYOCARDIAL INFARCTION: RELATION BETWEEN DISEASE SEVERITY AND MATRIX METALLOPROTEINASE – 1, AND EFFECTS OF MAGNESIUM PRETREATMENT ON REPERFUSION INJURY.

Revista Magnesium Reserch – volume 16 – ano 2003 Número 2; páginas 120- 126.

Autores:

1) Kenji Ueshima – The Second department of internal Medicine, Iwate Medical University, Morioka, Japan.

2) Masashi Shibata – The Critical Care and Emergency Center, Iwate Medical University, Morioka, Japan.

3) Tomomi Suzuki -  The Critical Care and Emergency Center, Iwate Medical University, Morioka, Japan.

4) Shigeatsu Endo - The Critical Care and Emergency Center, Iwate Medical University, Morioka, Japan.

5) Katsuhiko Hiramori - The Second department of internal Medicine, Iwate Medical University, Morioka,
    Japan.
 

Summary:

 Purpose: The purpose of this paper is to clarify the relationship between cytokines, matrix metalloproteinase – 1 (MMP – 1) and severity of acute myocardial infarction (AMI). Additionally, to investigate whether magnesium (Mg) sulfate pretreatment inhibits myocardial damage in coronary reperfusion therapy for patients with AMI. Subjects: At firs, 34 patients with AMI were enrolled. Then, the patients were classified into 2 groups with or without congestive health failure (CHF) (C group and NC group, respectively). Interleukin 6 (IL-6), MMP-1 and the
homodynamic parameters were measured. Second, 36 AMI patients treated with coronary reperfusion therapy were enrolled. Patients were divided into 2 groups (18 patients  each) as the non-pretreated group (Control group) and the group pretreated with intravenous Mg sulfate (0.27 mmol/kg) (Mg group). IL-6, MMP-1 and indexes of reperfusion injury were evaluated. Results: there were positive correlations between peak MMP-1 level, and peak creatine kinase value and pulmonary capillary wedge pressure and peak IL-6 level (r=0.43, r=0.70, and r=0.60, respectively) in all patients. There were negative correlations between 0peak MMP-1 level and left ventricular ejection fraction and cardiac index (r=-0.52 an r= - 0.55, respectively). The peak blood IL-6 and MMP-1 level increased in AMI, particularly in patients with CHF ( C groups vs NC group; 130 vs 51 pg/mL, both p < 0.01). Additionally, peak IL-6 and peak MMP-! in the Mg group were lower than those of the control group (39 vs 92 pg/mL and 16 vs 20 ng/mL p<0.05 and p=0.09, respectively).  The incidence of reperfusion injury including reperfusion arrhythmia and transient exacerbation of ST elevation in the Mg group was lower than that of control group (17 vs 78% and 2.5 vs 4.7mm, p < 0.01 and p=0.08, respectively). Conclusion: These results may suggest that the severity of AMI is reflected by the blood IL-6 and MMP-1 levels and the pretreatment with Mg administration protects the myocardiumof patients with AMI from reperfusion injury induced by IL-6 and MMP-1.