The mitral valvular disease is strongly related to atrial fibrillation (AF). The impact of matrix metalloproteinases (MMPs) on structural atrial remodeling and sustainment of AF in patients with AF is unresolved.

This study aimed to investigate serum metalloproteinases as markers of atrial remodeling in patients with mitral stenosis.

Blood sample, clinical and echocardiographic parameters were evaluated in 73 patients with mitral stenosis: 37 with AF and 36 with sinus rhythm. The Plasma levels of MMP-3, MMP-2, MMP-9 and TIMP-1 were measured by ELISA sandwich assay.

The concentration of MMP-3 (P=0.05) was significantly higher in patients with AF than in patients with sinus rhythm. After adjusting for age, gender, and treatment, the regression model indicates that the high MMP-3 appears to be a risk factor for AF (OR=1.5, P=0.001). ROC curve showed that plasma levels of MMP-3 can be predict atrial remodeling in patient with mitral stenosis at the cutoff value of>9.05ng/ml with an area under the curve (AUC=0.618, P=0.038). The combined analysis with the receiver-operating curve of matrix parameters shows a strong association with AF where we observed an increased area (0.706, P=0.004).

Elevated level of MMP-3 was related to the occurrence of AF. This suggests that MMP-3 could be a marker of atrial remodeling in patients with AF.