{"doi":"10.1161/circheartfailure.123.010849","title":"MMP-2 Associates With Incident Heart Failure and Atrial Fibrillation: The ARIC Study","abstract":"BACKGROUND: MMP (matrix metalloproteinase)-2 participates in extracellular matrix regulation and may be involved in heart failure (HF), atrial fibrillation (AF), and coronary heart disease. METHODS: Among the 4693 ARIC study (Atherosclerosis Risk in Communities) participants (mean age, 75±5 years; 42% women) without prevalent HF, multivariable Cox proportional hazard models were used to estimate associations of plasma MMP-2 levels with incident HF, HF with preserved ejection fraction (≥50%), HF with reduced ejection fraction (<50%), AF, and coronary heart disease. Mediation of the association between MMP-2 and HF was assessed by censoring participants who developed AF or coronary heart disease before HF. Multivariable linear regression models were used to assess associations of MMP-2 with measures of left ventricular and left atrial structure and function. RESULTS: Compared with the 3 lower quartiles, the highest MMP-2 quartile associated with greater risk of incident HF overall (adjusted hazard ratio, 1.48 [95% CI, 1.21–1.81]), incident HF with preserved ejection fraction (1.44 [95% CI, 1.07–1.94]), incident heart failure with reduced ejection fraction (1.48 [95% CI, 1.08–2.02]), and incident AF (1.44 [95% CI, 1.18–1.77]) but not incident coronary heart disease (0.97 [95% CI, 0.71–1.34]). Censoring AF attenuated the MMP-2 association with HF with preserved ejection fraction. Higher plasma MMP-2 levels were associated with larger left ventricular end-diastolic volume index, greater left ventricular mass index, higher E/e′ ratio, larger left atrial volume index, and worse left atrial reservoir and contractile strains (all P <0.001). CONCLUSIONS: Higher plasma MMP-2 levels associate with diastolic dysfunction, left atrial dysfunction, and a higher risk of incident HF and AF. AF is a mediator of MMP-2–associated HF with preserved ejection fraction risk.","journal":"Circulation Heart Failure","year":2023,"id":337644,"datarank":0.44166584687496613,"base_score":2.9444389791664403,"endowment":2.9444389791664403,"self_citation_contribution":0.44166584687496613,"citation_network_contribution":0.0,"self_endowment_contribution":0.44166584687496613,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":18,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9584,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":620619,"name":"Ali Agha","orcid":"0000-0003-3620-7241","position":1,"is_corresponding":false},{"id":1069497,"name":"Pranav Dorbala","orcid":"0000-0002-7764-0802","position":2,"is_corresponding":false},{"id":28286,"name":"Brian Claggett","orcid":"0000-0002-4215-9218","position":3,"is_corresponding":false},{"id":51217,"name":"Bing Yu","orcid":"0000-0003-4818-1077","position":4,"is_corresponding":false},{"id":513860,"name":"Aliza Hussain","orcid":"0000-0002-1264-8707","position":5,"is_corresponding":false},{"id":326870,"name":"Vijay Nambi","orcid":"0000-0002-4237-0267","position":6,"is_corresponding":false},{"id":55689,"name":"Lin Y. Chen","orcid":"0000-0002-0700-814X","position":7,"is_corresponding":false},{"id":22652,"name":"Kunihiro Matsushita","orcid":"0000-0002-7179-718X","position":8,"is_corresponding":false},{"id":233724,"name":"Ron C. Hoogeveen","orcid":"0000-0003-2399-4653","position":9,"is_corresponding":false},{"id":233725,"name":"Christie M. Ballantyne","orcid":"0000-0002-6432-1730","position":10,"is_corresponding":false},{"id":262832,"name":"Amil M. Shah","orcid":"0000-0003-1056-4451","position":11,"is_corresponding":false},{"id":647495,"name":"Leo F. Buckley","orcid":"0000-0003-1570-1486","position":0,"is_corresponding":true}],"reference_count":27,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T01:10:31.133446Z","pmid":"37753653","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}