title: Circulating matrix metalloproteinases and tissue inhibitors of metalloproteinases levels in pediatric patients with congenital heart disease: Relationship to cardiac functions.
abstract: OBJECTIVE
  The pathological effects of matrix metalloproteinases and their tissue inhibitors in cardiovascular diseases are of considerable interest. In our study, we aimed to determine and evaluate the potential significance of circulating matrix metalloproteinases-2 and 9, tissue inhibitors of matrix metalloproteinases-1 and 2 levels in four patient subgroup of pediatric cardiology field and expose pathophysiologic differences between these groups.
  
  
  METHODS
  Eighty-seven patients with the diagnosis of congenital heart disease and 47 healthy controls were enrolled in the study. The study group was stratified to 4 subgroups; 14 patients with right ventricular volume overload, 30 patients with left ventricular volume overload, 19 patients with left to right shunt who developed pulmonary hypertension and 24 patients with cyanotic congenital heart disease. For evaluation of the relationships between serum matrix metalloproteinases and their tissue inhibitors levels with cardiac structures and functions; complete blood count, arterial oxygen saturation, detailed echocardiographic measurements (including tissue Doppler) in all patients and hemodynamic parameters of the patients who went to cardiac catheterization were recorded. Serum matrix metalloproteinase levels were determined by ELISA test. Statistical evaluations were performed with SPSS 16.0. For parameters showing normal distribution, comparisons were made with t-test and ANOVA test. However, for parameters without normal distribution, groups were compared with Mann-Whitney U test and Kruskal-Wallis test.
  
  
  RESULTS
  We demonstrated that serum tissue inhibitors of matrix metalloproteinases-1 levels of patients with pulmonary hypertension secondary to congenital heart diseases were significantly higher than the patients with left to right shunt without pulmonary hypertension and controls (p<0.01). Although serum matrix metalloproteinases and their tissue inhibitors levels in patients with cyanotic congenital heart diseases and patients with right or left ventricular volume overload were found to be altered when compared with controls but not significant.
  
  
  CONCLUSIONS
  Our data may suggest the possible role of matrix metalloproteinases and their tissue inhibitors on myocardial remodeling in congenital heart defects and especially in patients who developed pulmonary hypertension.
authors.affiliation: Department of Pediatric Cardiology, Faculty of Medicine, Eskişehir Osmangazi University; Eskisehir-Turkey. drbucar@yahoo.com.
authors.forename: Zübeyir
authors.initials: Z
authors.lastname: Kiliç
authors.forename: Birsen
authors.initials: B
authors.lastname: Uçar
authors.forename: Gökmen
authors.initials: G
authors.lastname: Özdemir
authors.forename: Ömer
authors.initials: Ö
authors.lastname: Colak
authors.forename: Cengiz
authors.initials: C
authors.lastname: Bal
authors.forename: Türkan
authors.initials: T
authors.lastname: Ertuğrul
mesh_terms: D016022:Case-Control Studies; D002648:Child; D005260:Female; D006330:Heart Defects, Congenital / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D008297:Male; D020782:Matrix Metalloproteinases / Q000097:blood*; D019714:Tissue Inhibitor of Metalloproteinases / Q000097:blood*; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging / Q000503:physiopathology
chemical_list: D019714:Tissue Inhibitor of Metalloproteinases; D020782:Matrix Metalloproteinases