The Relationship between Plasma ADAMTS 7 Level and Left Ventricular Remodeling after Acute Myocardial Infarction

Abstract
Background: Left Ventricular (LV) dysfunction is the single strongest predictor of mortality following ST elevation myocardial infarction and is one of the most frequent and deadly complications of non ST elevation myocardial infarc-tion. Degradation of Extracellular Matrix (ECM) causes progressive thinning and dilatation of infarct zone and con-tributes to serious complication as ventricular dilatation, dysfunction, aneurysm and even rupture. The matrix metallo-proteinase-mediated degradation and remodeling of ECM plays an essential role in these disease processes.
Aim of the Study: It was to evaluate the relationship between plasma ADAMTS 7 level and left ventricular remod-eling after acute myocardial infarction.
Patients and Methods: This study was carried on fifty cases that were divided into two main categories according to their health status. Diseased group included twenty five patients diagnosed as acute myocardial infarction with newly S-T segment elevation. Based on their echocardiographic examination, patients were classified into two groups patients; a group of 16 patients with ejection fraction of more or equal 40 (group I; G1) and 9 patients with an ejection fraction of less than 40 (group II; G2). Control group included twenty five apparently healthy persons serving as controls (group III; G 3). All studied cases were subjected to detailed clinical history, thorough clinical examination, Electrocardiogram (ECG), trans-thoracic Echocardiography (ECHO), routine laboratory investigation included: Cardiac markers, renal function tests, liver function tests, lipid profile, serum elec-trolytes, complete blood picture and special laboratory inves-tigation: Plasma adamts-7 levels measurement by ELISA technique.
Results: There was statistically significant increase in ADAMTS 7 concentration in group II (patients with ejection fraction <40) as compared with both group I (patients with ejection fraction >_40) and group III (controls), while there was no statistically significant difference between group I and group III. There was a statistically significant negative correlation between ADAMTS 7 concentration and both ejection fraction and fractional shortening in acute myocardial infarction patients. While there was a statistically significant positive correlation between ADAMTS 7 concentration and both left ventricular end diastolic diameter and left ventricular end systolic diameter in acute myocardial infarction patients.
Conclusion: The results of this research showed that there was a significant increase in the mean value of ADAMTS 7 levels in patients with ejection fraction <40% than in patients with ejection fraction >_40%, so it may be used as a strong predictor for the development of left ventricular remodeling after acute myocardial infarction and this may be of a great value as a therapeutic target.