A possible explanation for RSD improving cardiac remodeling following MI could be attributed to the development of a feed-forward loop whereby the tumor growth factor β1 (TGF-β1) increases MMP-9 and MMP-2; however, both MMP-9 and MMP2 can also cleave latent TGF-β1 and release its active form, which activates the transcription of TIMPs [147]. Here, MMP2 is linked to myocardial infarction.