title: [Expression and significance of matrix metalloproteinase-1,9, tissue inhibitor of metalloproteinase-4 and extracellular matrix metalloproteinase inducer in the myocardium of congestive heart failure in patients with rheumatic heart diseases].
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Cardiothoracic Surgery, Second Xiangya Hospital, Central South University, Changsha 410011, China. zhaoyuan937@yahoo.com.cn
authors.forename: Yuan
authors.initials: Y
authors.lastname: Zhao
authors.forename: Xinmin
authors.initials: X
authors.lastname: Zhou
authors.forename: Xiaobo
authors.initials: X
authors.lastname: Liao
authors.forename: Zhulin
authors.initials: Z
authors.lastname: Yang
mesh_terms: D000328:Adult; D000368:Aged; D051926:Basigin / Q000378:metabolism*; D016022:Case-Control Studies; D005260:Female; D006333:Heart Failure / Q000209:etiology / Q000378:metabolism*; D006801:Humans; D008297:Male; D020781:Matrix Metalloproteinase 1 / Q000378:metabolism*; D020780:Matrix Metalloproteinase 9 / Q000378:metabolism*; D008875:Middle Aged; D012214:Rheumatic Heart Disease / Q000150:complications / Q000378:metabolism*; D019714:Tissue Inhibitor of Metalloproteinases / Q000378:metabolism*; D000097792:Tissue Inhibitor of Metalloproteinase-4
chemical_list: D051926:Basigin; D020781:Matrix Metalloproteinase 1; D020780:Matrix Metalloproteinase 9; D019714:Tissue Inhibitor of Metalloproteinases; D000097792:Tissue Inhibitor of Metalloproteinase-4; C497886:BSG protein, human; C522360:MMP1 protein, human