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Background:Increase in serum matrix metalloproteinases(MMPs) levels plays an important role in the pathogenesis of myocardial remodeling. The objective is to estimate the repetitive measurement of serum MMPs levels in patients after myocardial infarction(MI)and to establish whether it is a useful parameter in monitoring myocardial remodeling.Methods and Results:Measurements of serum MMPs level were repeated in 6 months interval after one year later of AMI. We compared the serial changes of MMP-2 with the changes of LVEDV at one year after the second MMP-2 measurement. Of the 71 patients, 33 had an increase of MMP-2 (I), whereas 30 had a decrease (D) and 8 patients had no change. In group I, the percent changes of LVEDV were higher than that of group D (18.5 ± 11% vs. -7.4 ± 11%, p < 0.001). The use of beta-blockers, ACE-inhibitors, and angiotensin receptor blockers was no difference between two groups, whereas the use of statin was more frequent in group D (53% vs. 12%, p < 0.01) than group I. Background of patients was no difference in hypertension and smoking rate, but relative high incidence of diabetes mellitus was found in group I (p=0.063).Conclusions:The increase of serum MMP-2 correlated with the enlargement of the LV volume thereafter. Therefore, the repetition of MMP-2 measurement may be helpful for predicting the later LV remodeling.

Purpose:The aim of this study is to elucidate the relationship between the extent of microvascular impairment assessed by Nitrogen-13 positron emission tomography (N-PET) and the improvement in left ventricular (LV) wall motion after acute myocardial infarction (AMI). Methods:We prospectively studied 12 patients (7 men, mean 69 yrs) with first AMI who were successfully reperfused. All patients had single vessel disease and showed no restenosis in infarct-related artery during observation periods. Myocardial flow reserve (MFR) was calculated using N-PET performed at 2 weeks. The extent of regional LV wall motion (RWM; SD/chords) in infarct-related segments (IRS) was assessed by contrast left ventriculography after 1 month and 6 months. Results:Of the total 84 segments, 33 were IRS. In the 33 infarct-related segments, 21 showed severe microvascular impairment (Group S; MFR < 2.0) and 11 showed mild microvascular impairment (Group M; MFR2.0). In Group M, the RWM significantly improved from 1month to 6months (−2.83 ± 1.49 to −1.49 ± 1.46, p=0.03), while it did not improve in group M. The MFR within IRS was more closely correlated with the RWM at 6 month (r=0.67, p < 0.0001) than with that at 1 month (r=0.40, p < 0.0001). Conclusion:Data indicated that late recovery of LV wall motion depends on the extent of preserved microvascular function after successful reperfusion in AMI patients.