{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T07:04:30Z","timestamp":1767337470912,"version":"3.40.4"},"reference-count":31,"publisher":"S. Karger AG","issue":"1","license":[{"start":{"date-parts":[[2013,1,1]],"date-time":"2013-01-01T00:00:00Z","timestamp":1356998400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2013,1,1]],"date-time":"2013-01-01T00:00:00Z","timestamp":1356998400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiology"],"published-print":{"date-parts":[[2013]]},"abstract":"<jats:p>&lt;b&gt;&lt;i&gt;Background and Objective:&lt;\/i&gt;&lt;\/b&gt; Our study aimed to elucidate the potential clinical and molecular issues in recurrent atrial fibrillation (AF) following a radiofrequency modified maze procedure in patients with rheumatic valvular disease and persistent AF. &lt;b&gt;&lt;i&gt;Methods and Results:&lt;\/i&gt;&lt;\/b&gt; Eighty patients with rheumatic valvular disease and persistent AF (lasting more than 6 months) who had undergone a radiofrequency modified maze procedure and mitral valve replacement were enrolled into this single-center pilot study and were followed up for another 6 months. Their clinical characteristics were analyzed and the expression of matrix metalloproteinase (MMP)-2 including its specific inhibitor and collagen volume fraction (CVF) was also assessed. During the 6-month follow-up, 24 subjects had recurrent AF. Among them, the left atrial diameter was larger compared to that achieved in sinus rhythm (SR). The mRNA and protein expression of MMP-2 was significantly increased in recurrent AF patients, while its specific inhibitor did not show a significant difference (p &gt; 0.05). The CVF of type I collagen increased significantly in the recurrent AF patients compared to SR patients (18.16 \u00b1 3.22 vs. 11.66 \u00b1 3.38, p &lt; 0.001), whereas the CVF of type III collagen showed no significant difference (8.33 \u00b1 3.44 vs. 9.55 \u00b1 3.67, p &gt; 0.05). &lt;b&gt;&lt;i&gt;Conclusion:&lt;\/i&gt;&lt;\/b&gt; This study suggests that the overexpression of MMP-2 is associated with CVF-I in the left atrial appendage which potentially leads to the recurrence of AF following a radiofrequency modified maze procedure in patients with rheumatic valve disease.<\/jats:p>","DOI":"10.1159\/000351980","type":"journal-article","created":{"date-parts":[[2013,7,17]],"date-time":"2013-07-17T07:10:44Z","timestamp":1374045044000},"page":"62-68","source":"Crossref","is-referenced-by-count":7,"title":["The Role of Matrix Metalloproteinase-2 in the Treatment of Atrial Fibrillation Recurrence after a Radiofrequency Modified Maze 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