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Cardiac Extracellular Matrix and Postinfarction Reparative Fibrosis (Part 2). P. 78–89

Версия для печати

Section: Medical and biological sciences

UDC

611-018.2:616.127-005.8-002.17-06:612.67

Authors

Anna N. Putyatina*, Lena B. Kim*
*Research Institute of Experimental and Clinical Medicine (Novosibirsk, Russian Federation)

Abstract

Complications of myocardial infarction quite often cause deaths and make the treatment of myocardial infarction much more difficult, especially in the elderly. Age-dependent modification of reparative fibrosis seems to underlie a worse prognosis in complicated myocardial infarction. This review attempts to characterize the most frequent complications of the disease on the basis of selected markers of reparative fibrosis. The mechanisms involved in the development of myocardial infarction complications are also covered. In addition, the article points out the changes in the levels of individual markers of reparative fibrosis and local regulation system in human and animal tissue and biological liquids. These changes cause modifications in postinfarction reparative fibrosis. In particular, collagen metabolism is increased in acute heart failure; at the same time the content of sulfated glycosaminoglycans rises when matrix metalloproteinase-2 and tissue inhibitor of matrix metalloproteinase-1 are activated. Moreover, increased collagen and proteoglycan metabolism as well as lower fibronectin content are observed against the background of higher level of tissue inhibitor of matrix metalloproteinase-1 when heart rhythm is disturbed. In heart aneurism, there is an accelerated degradation of collagen with low levels of sulfated glycosaminoglycans and matrix metalloproteinase-9 and a high level of tissue inhibitor of matrix metalloproteinase-1. In cardiac rupture, possibly due to tenascin C stimulation, the content of matrix metalloproteinase-8 and -9 increases, which may disrupt the connection between cardiomyocytes and the extracellular matrix. Further, it was shown that changes in titin level and in its association with cardiomyocyte contractile proteins and collagen can promote fibrosis as well as diastolic and systolic dysfunction. These findings provide completely new insights into the role of reparative fibrosis markers in pathological remodelling of cardiac extracellular matrix in complicated disease. To find pharmacological targets and develop a timely treatment strategy in adverse outcomes we need to study metabolism regulation of extracellular matrix components in complicated myocardial infarction.

Keywords

myocardial infarction complications, reparative fibrosis, collagens, proteoglycans, fibronectin
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