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1 Division of Cardiothoracic Surgery, Medical University of South Carolina, Charleston, SC, USA; Division of Pediatric Cardiology, Medical University of South Carolina, Charleston, SC, USA
2 Division of Cardiothoracic Surgery, Medical University of South Carolina, Charleston, SC, USA
3 Division of Pediatric Cardiology, Medical University of South Carolina, Charleston, SC, USA
* To whom correspondence should be addressed. E-mail: mukherr{at}musc.edu.
Background: Discrete myocardial lesions created through the delivery of radiofrequency (RF) energy can expand; however, the mechanisms have not been established. Matrix metalloproteinases (MMPs) play an important role in myocardial remodeling and MMP activity can be regulated by the tissue inhibitors of the metalloproteinases (TIMPs). This study examined the role of TIMP-1 in post-injury myocardial remodeling. Methods and Results: Lesions were created on the left ventricular epicardium of wild-type (WT, 8-12 weeks, 129SVE) and age-matched TIMP-1 gene deficient (timp-1-/-) mice through the delivery of RF current (80oC, 30 s). Heart mass, LV scar volumes, and collagen content were measured at 1 hr, 3 days, 7 days, and 28 days post-injury (n=10 each). Age matched, non-ablated mice were used as reference controls (n=5). Heart mass indexed to tibial length increased in WT and timp-1-/- mice, but was greater in the timp-1-/- mice by 7 days. Scar volumes increased in a time-dependent manner in both groups, but were higher in the timp-1-/- mice than the WT mice at 7 days (1.48±0.09 vs. 1.20±0.11 mm3/mg/mm, p<0.05), and remained higher at 28 days. In the remote myocardium, wall thickness was greater and relative collagen content was lower in the timp-1-/- mice at 28 days post-injury. Conclusions: Discrete myocardial RF lesions expand in a time-dependent manner, associated with myocyte hypertrophy remote to the scar. Moreover, post-injury myocardial remodeling was more extensive with TIMP-1 gene deletion. Thus, TIMP-1 either directly, or through modulation of MMP activity, may regulate myocardial remodeling following infliction of a discrete injury.
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