Department of Cardiology, Foshan First Hospital of Guangdong, Foshan, China.
J Cardiovasc Med (Hagerstown). 2013 Apr;14(4):265-9. doi: 10.2459/JCM.0b013e328354e458.
To explore the expression of matrix metalloproteinase and tissue inhibitor of metalloproteinase of atrial myocardial structure of rheumatic and coronary heart disease.
Fifty patients with rheumatic heart disease (RHD) undergoing artificial mitral valve replacement surgery were selected: 20 with sinus rhythm and 30 with atrial fibrillation. Another 40 patients with coronary artery disease (CAD) undergoing coronary artery bypass surgery were selected: 22 with myocardial infarction (MI) and 18 with unstable angina. During thoractomy, samples of the right auricle were taken and immunohistochemical staining and fluorescence quantitative PCR were performed to test matrix metalloproteinase (MMP) 1, MMP-3, MMP-7, MMP-9, tissue inhibitor of metalloproteinase (TIMP) 1, TIMP-2, TIMP-3 and TIMP-4 expression of the samples.
In RHD, the left and right atrial diameters of the atrial fibrillation group were significantly larger than those of the sinus rhythm group (P < 0.01), but there was no significant difference between the left ventricular diastolic diameter and the left ventricular ejection. The immunohistochemical staining and real-time (RT)-PCR show that the expression of MMP-3, MMP-7, MMP-9, TIMP-1, TIMP-2, TIMP-3 and TIMP-4 were significantly increased in the atrial fibrillation group compared with the sinus rhythm group (all P < 0.01). The difference in MMP-1 of the two groups was not statistically significant. In CAD patients, the left and right atrial diameters and left ventricular diameter of the MI group were significantly larger than those of the unstable angina group (P < 0.01), but the left ventricular ejection fraction was obviously lower than that of the unstable angina group (P < 0.05). Immunohistochemical staining and RT-PCR show that the expression of MMP-3, MMP-9, TIMP-1 TIMP-2, TIMP-3, TIMP-4 were significantly increased in MI group compared with the unstable angina (P < 0.01, P < 0.01, P < 0.05, P < 0.05, P < 0.01 and P < 0.01, respectively).
The expression of MMPs and TIMPs increased in RHD patients and MI patients. Regulating the expression and activity of MMPs and TIMPs may be an important clinical treatment and method to prevent, and even reverse, atrial remodeling.
探讨风湿性心脏病（RHD）和冠心病患者心房心肌结构中基质金属蛋白酶（MMP）和组织金属蛋白酶抑制剂（TIMP）的表达。
选择 50 例行二尖瓣置换术的风湿性心脏病患者：窦性心律 20 例，心房颤动 30 例。另选择 40 例行冠状动脉旁路移植术的冠心病患者：心肌梗死（MI）22 例，不稳定型心绞痛 18 例。开胸时取右心耳组织标本，行免疫组化染色和荧光定量 PCR 检测 MMP1、MMP-3、MMP-7、MMP-9、TIMP1、TIMP-2、TIMP-3、TIMP-4 的表达。
在 RHD 中，心房颤动组的左右心房直径明显大于窦性心律组（P<0.01），但左心室舒张直径和左心室射血分数无明显差异。免疫组化染色和实时（RT）-PCR 显示，与窦性心律组相比，心房颤动组 MMP-3、MMP-7、MMP-9、TIMP-1、TIMP-2、TIMP-3 和 TIMP-4 的表达均明显增加（均 P<0.01）。两组 MMP-1 差异无统计学意义。在 CAD 患者中，MI 组的左右心房直径和左心室直径明显大于不稳定型心绞痛组（P<0.01），但左心室射血分数明显低于不稳定型心绞痛组（P<0.05）。免疫组化染色和 RT-PCR 显示，与不稳定型心绞痛组相比，MI 组 MMP-3、MMP-9、TIMP-1、TIMP-2、TIMP-3、TIMP-4 的表达明显增加（P<0.01、P<0.01、P<0.05、P<0.05、P<0.01 和 P<0.01）。
RHD 患者和 MI 患者 MMPs 和 TIMPs 的表达增加。调节 MMPs 和 TIMPs 的表达和活性可能是预防甚至逆转心房重构的重要临床治疗和方法。
