Obstructive Lung Diseases |

Serum Metalloproteinase-9 and Consistent Cardiovascular Remodeling in Chronic Cor Pulmonale Dyspnea Patients, Coincident With Atrial Fibrilation. Fact or Fiction? FREE TO VIEW

Ioannis Angomachalelis, PhD; George Kyriazis, PhD; Nestor Angomachalelis, PhD
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Aristotle University of Thessaloniki School of Medicine, Department of Medicine, Clinical Pulmonology, Heart-Lung Section, "G.Papanickolaou" General Hospital, Thessaloniki, Greece

Chest. 2013;144(4_MeetingAbstracts):685A. doi:10.1378/chest.1704509
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SESSION TITLE: Biomarkers for COPD

SESSION TYPE: Original Investigation Slide

PRESENTED ON: Wednesday, October 30, 2013 at 07:30 AM - 09:00 AM

PURPOSE: Clinical Dyspnea in Chronic Cor Pulmonale(CCP) and coincident Atrial Fibrilation (AF) could be a result of either respiratory impairment or cardiovascular remodeling or both.The present study of serum MMP-9 aims to investigate the differential cause of dyspnea,distinguishing between the reported pathophysiologies.

METHODS: Clinical Examination,ECG,Pulmonary Function Tests and Arterial Blood Gasses, Echocardiography and serum Biomarkers determination,including MMP-9,were applied in 33 Patients(Pts) (mean age 73.7±7 years) and 45, mutched control, normal individuals.Multiple statistical correlations among all reported indices were made.

RESULTS: The results showed 1. Clinical evidence of CCP and arrhythmias 2. ECG abnormalities of AF and signs of CCP 3a. TLC=64.7% pred ,FEV1=57% pred , FVC=58% pred 3b. PO2=60.5 mm Hg , P(A-a)O2 =37.6 mm Hg 4. EF =58% , LAD = 4.9 cm, RVSP =45.5 mm Hg 5. MMP-9 =910 ng/ml 6 . Serum MMP-9 correlation with a) RVSP (r=-0.660) b) LAD (r=-0.570) and c) Serum Na (r=-470) 7. No significant statistical correlations were found between serum MMP-9 and abnormal pulmonary function tests or arterial blood gasses.

CONCLUSIONS: We conclude that 1. CCP and AF are co-existed 2. Respiratory function tests of mixed pattern,primarily of restrictive type were confirmed 3 .Left ventricular dysfunction with preserved systolic function was indicated 4 . Consistent increace of LAD,serum Na levels and RVSP were strongly correlated with decreased MMP-9,indicating cardiovascular remodeling mainly of left ventricular origin 5. Clinical dyspnea predominantly relies on left ventricular cardiovascular remodeling, while 6 . abnormal pulmonary function tests and blood gasses, due to CCP and atrial dysfunction, represent quite independent indices of the reported clinical dyspnea.

CLINICAL IMPLICATIONS: Combined research studies should be made to confirm the diagnostic utility of serum MMP-9 index, determining cardiovascular remodeling in Chronic Cor Pulmonale and Atrial Fibrilation dyspnea Pts.

DISCLOSURE: The following authors have nothing to disclose: Ioannis Angomachalelis, George Kyriazis, Nestor Angomachalelis

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