Saglam Mustafa, Karakaya Osman, Esen Ali Metin, Barutcu Irfan, Dogan Serkan, Karavelioglu Yusuf, Karapinar Hekim, Akgun Taylan, Esen Ozlem, Ozdemir Nihal, Turkmen Sembol, Kaymaz Cihangir
Department of Cardiology, Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey.
Tohoku J Exp Med. 2006 Feb;208(2):117-22. doi: 10.1620/tjem.208.117.
Matrix metalloproteinases (MMPs) are involved in the regulation of the extracellular matrix (ECM) of the myocardium and thus the pathogenesis of vascular and cardiac hypertrophy. In this study, we investigated contribution of plasma matrix metalloproteinases to development of left ventricular hypertrophy (LVH) and diastolic dysfunction in hypertensive subjects. Hypertensive patients with (n = 27) and without LVH (n = 23) were included. All participants underwent a complete transthoracic echocardiographic examination, including recordings of the mitral annular early, late, systolic and diastolic velocities by Doppler imaging. Plasma concentrations of MMP-3 and MMP-9 were determined by the one-step sandwich enzyme immunoassay method. Plasma MMP-3 and MMP-9 concentrations were significantly higher in patients with LVH than those without LVH (2.4 +/- 1.2 vs 1.5 +/- 0.7 ng/ml, p = 0.006 and 5.2 +/- 2.8 vs 3.3 +/- 1.7 ng/ml, p = 0.003, respectively). MMP-3 and MMP-9 levels were also correlated with left ventricular posterior wall thickness and Doppler indices of diastolic dysfunction. Our findings have suggested that increased MMP levels may contribute to LVH and left ventricular diastolic dysfunction. Therefore, treatment of hypertension with MMP lowering drugs, such as angiotensin converting enzyme inhibitors and angiotensin receptor blockers, may have favorable effects on LVH and left ventricular diastolic dysfunction.
基质金属蛋白酶（MMPs）参与心肌细胞外基质（ECM）的调节，进而参与血管和心脏肥大的发病机制。在本研究中，我们调查了血浆基质金属蛋白酶在高血压患者左心室肥厚（LVH）和舒张功能障碍发生中的作用。纳入了有LVH的高血压患者（n = 27）和无LVH的高血压患者（n = 23）。所有参与者均接受了完整的经胸超声心动图检查，包括通过多普勒成像记录二尖瓣环的早期、晚期、收缩期和舒张期速度。采用一步夹心酶免疫测定法测定血浆MMP-3和MMP-9浓度。LVH患者的血浆MMP-3和MMP-9浓度显著高于无LVH患者（分别为2.4±1.2 vs 1.5±0.7 ng/ml，p = 0.006；5.2±2.8 vs 3.3±1.7 ng/ml，p = 0.003）。MMP-3和MMP-9水平还与左心室后壁厚度和舒张功能障碍的多普勒指标相关。我们的研究结果表明，MMP水平升高可能导致LVH和左心室舒张功能障碍。因此，使用降低MMP的药物（如血管紧张素转换酶抑制剂和血管紧张素受体阻滞剂）治疗高血压可能对LVH和左心室舒张功能障碍有有益影响。
