Pacing-induced cardiomyopathy: Pathophysiological insights through matrix metalloproteinases

Fozia Z. Ahmed, Rajdeep S. Khattar, Amir M. Zaidi, Ludwig Neyses, Delvac Oceandy, Mamas Mamas

    Research output: Contribution to journalArticlepeer-review

    Abstract

    Pacing-induced ventricular dysfunction and pacing-induced cardiomyopathy (PiCMP) are recognized complications of chronic right ventricular pacing. Alterations in myocardial perfusion and sympathetic innervation contribute to the development of pacing-induced heart disease. However, it is unlikely that these are the only processes involved. Matrix metalloproteinases (MMPs) are proteolytic enzymes that degrade the collagenous extracellular matrix and play a central role in left ventricular remodelling during the development of heart failure. While the pathophysiological mechanisms and altered MMP expression that occur in chronic pressure overload, ischaemic and non-ischaemic dilated cardiomyopathy have been defined, those that occur in the clinical setting of pacing-induced ventricular dysfunction and PiCMP have not been reported. Here we review the clinical epidemiology of pacing-induced ventricular dysfunction and discuss how data derived from animal models provide insight into how changes in MMP expression and function contribute to the development of PiCMP. The review concludes by exploring pacing strategies that may be used to prevent pacing-induced ventricular dysfunction. © Springer Science+Business Media 2013.
    Original languageEnglish
    Pages (from-to)669-680
    Number of pages11
    JournalHeart Failure Reviews
    Volume19
    Issue number5
    DOIs
    Publication statusPublished - 2014

    Keywords

    • Heart failure
    • Left ventricular dyssynchrony
    • Matrix metalloproteinases
    • Pacemakers
    • Pacing-induced cardiomyopathy
    • Right ventricular pacing

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