Phatharajaree Wannakorn, Phrommintikul Arintaya, Chattipakorn Nipon
Department of Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Can J Cardiol. 2007 Jul;23(9):727-33. doi: 10.1016/s0828-282x(07)70818-8.
Acute myocardial infarction (AMI) is currently one of the most important health problems in many countries around the world. Following AMI, many cytokines and proteolytic enzymes are released. Among these, matrix metalloproteinases (MMPs) are important proteolytic enzymes that lead to degradation of the extracellular matrix and to changes in cardiomyocytes in both infarcted and noninfarcted myocardium. This process is known as cardiac remodelling. It has been demonstrated that more than one type of MMP is present in the circulation after cardiomyocyte injury. A number of studies have demonstrated the correlations between these MMP levels and the severity of a coronary lesion, the progression of left ventricular dimension and the survival rate following AMI in both animal and human studies. MMPs have also been proposed as a possible novel prognostic indicator for myocardial infarction patients. Although the use of MMP inhibitors to improve cardiac outcome in AMI patients has been investigated, discrepancies in the results from those studies indicate that further research is still needed to warrant their beneficial effects. In the present review article, the roles of MMPs as prognostic indicators, as well as the factors influencing MMP expression, are discussed. Current findings on the role of MMP inhibitors in cardiac remodelling and the prognosis after AMI in both animal models and clinical studies are also examined.
急性心肌梗死（AMI）是目前世界上许多国家最重要的健康问题之一。急性心肌梗死后，会释放许多细胞因子和蛋白水解酶。其中，基质金属蛋白酶（MMPs）是重要的蛋白水解酶，可导致细胞外基质降解以及梗死心肌和非梗死心肌中心肌细胞的变化。这个过程被称为心脏重塑。已经证明，心肌细胞损伤后循环中存在不止一种类型的MMP。许多研究在动物和人体研究中都证明了这些MMP水平与冠状动脉病变的严重程度、左心室大小的进展以及急性心肌梗死后的生存率之间的相关性。MMPs也被提议作为心肌梗死患者可能的新型预后指标。尽管已经研究了使用MMP抑制剂来改善急性心肌梗死患者的心脏结局，但这些研究结果存在差异，表明仍需要进一步研究以证实其有益效果。在本综述文章中，讨论了MMPs作为预后指标的作用以及影响MMP表达的因素。还研究了动物模型和临床研究中MMP抑制剂在心脏重塑和急性心肌梗死后预后方面作用的当前研究结果。
