Assessment of Cardiac Remodeling in Patients with Chronic Heart Failure Condition and the Clinical Significance / 昆明医科大学学报

ABSTRACT

Objective To investigate the significance of MMP-9 and TIMP-1 test for assessing the occurrence and development of chronic heart failure.Methods One hundred and twenty-seven patients with chronic heart failure were enrolled in the observation group,and 40 cases community health people were selected for the control group. The levels of serum MMP-9 and TIMP-1 were detected and the LVEF and E/E ' were evaluated using endocardiography. Results Compared with the control group, the level of MMP-9 was significantly higher (<0.01) but the level of TIMP-1 had significantly decreased ( <0.05) in the observation group. And the ratio of MMP-9 and TIMP-1 had significantly increased compared with the control group ( <0.05) . There were statistically significant differences of LVEF and E/E' between the observation group and control group ( <0.05) . In the observation group,the level of MMP-9, MMP-9/TIMP-1,LVEF and E/E' were increased but the level of TIMP-1 decreased significantly in cases with cardiac functional class III compared with cardiac function class II (<0.05) . There were significant differences between the cases with class IV heart function and class II, III in the levels of MMP-9, TIMP-1 and MMP-9/TIMP-1 ( <0.05) . In the cases of class IV heart function, the LVEF and E/E' have significantly increased compared with the cases of class II ( <0.05) . MMP-9 + TIMP-1 +MMP-9/TIMP-1 combination has higher sensitivity and specificity than the MMP-9,TIMP-1 and MMP-9/TIMP-1 single indicator, and the joint diagnostic value of LVEF + E/E' was less than that of IL-18+ NT-ProBNP. Conclusion The levels of MMP-9 and TIMP-1 and their ratio may have contributed to the early detection and diagnosis for chronic heart failure,and help to determine the disease progression.