Zhao Yuan, Zhou Xinmin, Liao Xiaobo, Yang Zhulin
Department of Cardiothoracic Surgery, Second Xiangya Hospital, Central South University, Changsha 410011, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2009 Aug;34(8):790-5.
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.
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.
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.
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.
研究基质金属蛋白酶-1、-9（MMP-1、9）、金属蛋白酶组织抑制剂-4（TIMP-4）及细胞外基质金属蛋白酶诱导剂（EMMPRIN）在风湿性心脏病充血性心力衰竭患者心肌中的表达情况。
选取18例风湿性心脏瓣膜置换术中出现心力衰竭的患者的左心室乳头肌标本，另取10例无心脏病的成人尸检正常标本。采用EnVision免疫组织化学法对标本进行染色，检测MMP-1、MMP-9、TIMP-4及EMMPRIN的表达。
心功能分级为Ⅲ级和Ⅳ级（纽约心脏协会Ⅲ级和Ⅳ级）患者心肌中MMP-1、MMP-9及EMMPRIN的表达显著高于心功能正常者（纽约心脏协会Ⅰ级）（P<0.05），但纽约心脏协会Ⅲ级与Ⅰ级之间MMP-1的表达除外。纽约心脏协会Ⅲ级和Ⅳ级患者的TIMP-4水平显著低于纽约心脏协会Ⅰ级患者（P<0.05）。心房颤动患者的MMP-1、MMP-9及EMMPRIN表达显著高于窦性心律正常的对照组（P<0.05），而心房颤动患者的TIMP-4水平明显低于窦性心律正常的对照组（P<0.05）。MMP-1、MMP-9及EMMPRIN的表达相互呈正相关，但与TIMP-4呈负相关。
风湿性心脏病充血性心力衰竭患者心肌中基质金属蛋白酶、金属蛋白酶组织抑制剂及细胞外基质金属蛋白酶诱导剂明显失衡。它们可能通过心肌重构在充血性心力衰竭中发挥重要作用。
