Expression and significance of matrix metalloproteinase-1,9, tissue inhibitor of metalloproteinase-4 and extracellular matrix metalloproteinase inducer in the myocardium of congestive heart failure in patients with rheumatic heart diseases / 中南大学学报(医学版)

ABSTRACT

OBJECTIVE@#To investigate the expression of the matrix metalloproteinase-1, -9 (MMP-1,9), and tissue inhibitor of metalloproteinase-4 (TIMP-4), extracellular matrix metalloproteinase inducer (EMMPRIN) in the myocardium of congestive heart failure in patients with rheumatic heart diseases.@*METHODS@#The papillary muscle specimens of the left ventricle were obtained from 18 patients with heart failure during rheumatic heart valve replacement, and the normal specimens were obtained from the autopsy of 10 adults without heart disease. The specimens were stained to examine the expression of MMP-1, MMP-9, TIMP-4, and EMMPRIN by the EnVision immunohistochemical assays.@*RESULTS@#The expressions of MMP-1, MMP-9, and EMMPRIN in the myocardium of the patients with the cardiac function classes III and IV (NYHA III and IV) were significantly higher than those the normal cardiac function (NYHA I) (P<0.05) except MMP-1 expression between NYHA III and I. The TIMP-4 level was significantly lower in patients with NYHA III and IV than that of the NYHA I ( P<0.05). The expression of MMP-1, MMP-9, and EMMPRIN was significantly higher in patients with atrial fibrillation than those in the control group with regular sinus rhythm (P<0.05), whereas the TIMP-4 level was obviously lower in patients with atrial fibrillation than that in the control group with regular sinus rhythm (P<0.05). The expressions of MMP-1, MMP-9, and EMMPRIN were positively correlated with each other, but were negatively correlated with TIMP-4.@*CONCLUSION@#MMPs, TIMP, and EMMPRIN were significantly unbalanced in the myocardium of congestive heart failure patients with rheumatic heart diseases. They may play an important role in congestive heart failure through myocardial remodeling.