Extracellular matrix biomarkers and transforming growth factor-β in hypertrophic cardiomyopathy: interaction between biomarkers

Significant dysregulation of matrix metalloproteinase (MMPs), their tissue inhibitors (TIMPs) and profibrotic cytokines have been reported in hypertrophic cardiomyopathy (HCM) and associated with adverse cardiac remodeling. We aim to investigate the relationship among MMPs, TIMPs, transforming growth factor-β (TGF-β) and amino terminal propeptide of type III procollagen (PIIINP) in HCM patients, and to explore their associations with clinical outcomes. We recruited 46 HCM patients and 49 controls, and measured biomarkers levels using ELISA. Receiver operating characteristic (ROC) analysis revealed the highest diagnostic sensitivity for MMP-2 (93.3%) and specificity for TGF-β (90%). Significant correlations were found between biomarkers and clinical parameters, including interactions between TGF-β and left ventricular mass, MMP-2 and intraventricular septum, PIIINP and maximal wall thickness. We suggest that TGF-β, with the highest specificity and MMP-2, with high sensitivity, may offer significant potential for identifying patients with HCM and serve as useful biomarkers for this disease.