Effect of Concomitant Chronic Obstructive Pulmonary Disease on Markers of Collagen Metabolism in Patients with Ischemic Heart Disease

Abstract

To study parameters of collagen myocardial metabolism in patients with ischemic cardiomyopathy (ICMP) and to assess the effect of concomitant chronic obstructive pulmonary disease (COPD) on their levels. We examined 130 patients with ICMP (mean age 55.5 [43; 63] years) and 42 patients with ICMP and COPD (mean age 54.8 [41; 63] years). Determination of serum levels of matrix metalloproteinase-1 (MMP-1), its tissue inhibitor (TIMP-1), transforming growth factor-β1 (TGF-β1), and autoantibodies to collagen types I and III was carried out with the help of commercial test systems based on the method of solidphase enzyme immunoassay. Calculation of the volume fraction of interstitial collagen (VFIC) of the myocardium was carried out by the method of J. Shirani. In patients with ICMP combined with COPD, as well as in patients with ICMP we found disbalance in the metabolism of collagen of the extracellular matrix. At the same time, in patients with ICMP+COPD, processes of collagen degradation at the background of extracellular matrix fibrosis were found to be even more pronounced than in patients with ICMP. This was evidenced by the absence of statistically significant differences in the myocardial VFIC (p=0.703), and the level of TGF-β1 (p=0.074), as well as statistically significant higher activity of MMP-1 (p=0.037), MMP-1 / TIMP-1 ratio (p=0.045), and production of autoantibodies to collagen types I and III (p=0.042, p=0.039, respectively). The presence of COPD in patients with ICMP is associated with increased disbalance of the proteolysis-antiproteolysis system in the direction of collagen breakdown that can lead to more pronounced structural changes of the myocardium, and, as consequence, to aggravate functional impairment of the organ.