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Cardiac Extracellular Matrix and Postinfarction Reparative Fibrosis (Part 2). P. 78–89
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Section: Medical and biological sciences
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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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