Serum MMP-9 Activity as a Diagnosing Marker for the Developing Heart Failure of Post MI Patients


Gwo-Ping Jong;Tsochiang Ma;Pesus Chou;Mu-Hsin Chang;Chieh-His Wu;Ping-Chun Li;Shin-Da Lee;Jer-Yuh Liu;Wei-Wen Kuo;Chih-Yang Huang

Key Words

myocardial infarction ; heart failure ; MMP-2 ; MMP-9


The Chinese Journal of Physiology

Volume or Term/Year and Month of Publication

49卷2期(2006 / 04 / 01)

Page #

104 - 109

Content Language


English Abstract

Myocardial infarction (MI) is the result, in mostly cases, of the destabilization and rupture of atherosclerotic lesions. The destruction of cardiac tissue resulting from myocardial ischemia could further result in heart failure. It has been suggested that plaque instability may be mediated by matrix metalloproteinase (MMP) family. Studies have identified increased MMP-2 and MMP-9 in human platelets, and acute myocardial infarction patients with elevated MMP-2 and MMP-9 levels. However, the alteration of MMP-2 and MMP-9 from post MI left ventricle remodeling to heart failure remains to be clarified. The purpose of this study is to investigate the serum concentrations and activities of MMP-2 and MMP-9 in the developing heart failure from post MI patients. Twenty eight patients with MI without heart failure (Killip FC Ⅰ) (group A; compensated) and twenty seven MI patients with heart failure (Killip Ⅱ-Ⅲ) (group B; decompensated) were collected to evaluate the serum levels and activities of MMP-2 and MMP-9 by ELISA and Zymography, respectively. It was observed that the both serum levels and activities of MMP-9 significantly increased (P<0.01) in decompensated group compared to compensated group, but there was no significant difference of serum MMP-2 levels and activities between two groups. The highly elevated serum MMP-9 concentration of decompensated patients is not related with inflammatory or localized infarct area of myocardium and the real mechanisms remain to be revealed. We suggest that the increase of MMP-9 levels and activity may be used as a new marker to diagnose the development of heart failure in patients with post MI, and provide the therapeutic implications in the future.

Topic Category 醫藥衛生 > 基礎醫學
  1. Wu, D.J.,Lin, J.A.,Chiu, Y.T.,Cheng, C.C.,Ueng, K.C.,Lin, C.S.,Huang, C.Y.(2003).Pathological and biochemical analysis of dilated cardiomyopathy of broiler chickens.Chinese J. Physiol.,46,19-26.
  2. Abou-Raya, S.,Naim, A.,Marzouk, S.(2004).Cardiac matrix remodeling in congestive heart failure: the role of matrix metalloproteinases.Clin. Invest. Med.,27,93-100.
  3. Altieri, P.,Brunelli, C.,Garibaldi, S.,Nicolino, A.,Ubaldi, S.,Spallarossa, P.,Olivotti, L.,Rossettin, P.,Barsotti, A.,Ghigliotti, G.(2003).Metalloproteinases 2 and 9 are increased in plasma of patients with heart failure.Eur. J. Clin. Invest.,33,648-656.
  4. Beatriz-Alvarez, M.D.,Carmen-Ruiz, M.D.,Pilar-Chacon, M.D.,Jose Alvarez-Sabin, M.D.,Manuel-Matas, M.D.(2004).Serum values of metalloproteinase-2 and metalloproteinase-9 as related to unstable plaque and inflammatory cells in patients with greater than 70% carotid artery stenosis.J. Vasc. Surg.,40,469-475.
  5. Caulfield, J.B.,Borg, T.K.(1979).The collagen network of the heart.Lab. Invest.,40,364-372.
  6. Cheung, P.Y.,Sawicki, G.,Wozniak, M.(2000).Matrix metalloproteinase-2 contributes to ischemia-reperfusion injury in the heart.Circulation,101,1833-1839.
  7. Etoh, T.,Joffs, C.,Deschamps, A.M.(2001).Myocardial and interstitial matrix metalloproteinase activity after acute myocardial infarction in pig.Am. J. Physiol. Heart Circ. Physiol.,281,987-994.
  8. Fernandez-Patron, C.,Martinez-Cuesta, M.A.,Salas, E.,Sawicki, G.,Wozniak, M.,Rado, M.W.(1999).Differential regulation of platelet aggregation by Matrix metalloproteinases-9 and -2..Thromb. Haemost,82,1730-1735.
  9. Gaudron, P.,Eilles, C.,Kugler, I.,Ertl, G.(1993).Progressive left ventricular dysfunction and remodeling after myocardial infarction: potential mechanisms and early predictors..Circulation,87,755-763.
  10. Inokubo, Y.,Hanada, H.,Ishizaka, H.(2001).Plasma levels of Matrix metalloproteinase-9 and tissue inhibitor of metalloproteinase-1 are increased in the coronary circulation in patients with acute coronary syndrome.Am. Heart J.,141,211-217.
  11. Jugdutt, B.I.(1993).Prevention of Ventricular remodeling post myocardial infarction: timing and duration of therapy.Can. J. Cardiol.,9,103-114.
  12. Jugdutt, B.I.(2003).Ventricular remodeling after infarction and the extracellular collagen matrix: When is enough enough?.Circulation,108,1395-1403.
  13. Kaden, J.J.,Dempfle, C.E.,Sueselbeck, T.(2003).Time-dependent changes in the plasma concentration of matrix metalloproteinase 9 after acute myocardial infarction..Cardiology,99,140-144.
  14. Kai, H.,Ikeda, H.,Yasukawa, H.,Kai, M.,Seki, Y.,Kuwahara, F.(1998).Peripheral blood levels of matrix metalloproteinases-2 and -9 are elevated in patients with acute coronary syndromes.J. Am. Coll Cardiol.,32,368-372.
  15. Lu, L.,Gunja-Smith, Z.,Woessner, J.F.(2000).Matrix metalloproteinase and collagen ultrastructure in moderate myocardial ischemia and reperfusion in vivo.Am. J. Physiol. Heart Circ. Physiol.,279,601-609.
  16. Nishikawa, N.,Yamamoto, K.,Sakata, Y.(2003).Differential activation of Matrix metalloproteinases in heart failure with and without ventricular dilation..Cardiovasc. Res.,57,766-774.
  17. Peterson, J.T.,Li, H.,Dillon, L.(2000).Evolution of Matrix metalloproteinase and tissue inhibitor during heart failure progression in infarcted rat..Cardiovasc. Res.,46,307-315.
  18. Pfeffer, M.A.,Braunwald, E.(1990).Ventricular remodeling after myocardial infarction: experimental observations and clinical implications.Circulation,81,1161-1172.
  19. Pirolo, J.S.,Hutchins, G.M.,Moore, G.W.(1986).Infarct expansion: pathologic analysis of 204 patients with a single myocardial infarct.J. Am. Coll Cardiol.,7,349-354.
  20. Romanic, A.M.,Burns-Kurtis, C.I.,Gout, B.(2001).Matrix metalloproteinase in cardiac myocytes follow myocardial infarction in the rabbit.Life Sci.,68,799-814.
  21. Rosemberg, G.A.,Navratil, M.,Barone, F.,Feuerstein, G.(1996).Proteolytic cascade enzymes increase in focal cerebral ischemia in rat..J. Cereb. Blood Flow Metab.,16,360-366.
  22. Sato, S.,Ashraf, M.,Millard, R.W.(1983).Connective tissue changes in early ischemia of porcine myocardium: an ultrastructural study.J. Mol. Cell Cardiol.,15,261-275.
  23. Schwartzkopff, B.,Fassbach, M.,Pelzer, B.,Brehm, M.,Strauer, B.E.(2002).Elevated serum markers of collagen degradation in patients with mild to moderate dilated cardiomyopathy.Eur. J. Heart Fail,4,439-445.
  24. Steinberg, J.,Fink, G.,Picone, A.,Searles, B.,Schiller, H.,Lee, H.M.,Nieman, G.(2001).Evidence of increased matrix metalloproteinase-9 concentration in patients following cardiopulmonary bypass.J. Extra Corpor. Technol.,33,218-222.
  25. Takahashi, S.,Barry, A.C.,Factor, S.M.(1990).Collagen degradation in ischemic rat hearts..Biochem. J.,265,233-241.
  26. Takeshita, S.,Tokutomi, T.,Kawase, H.,Nakatani, K.,Tsujimoto, H.,Kawamura, Y.,Sekine, I.(2001).Elevated serum levels of matrix metalloproteinase-9 (MMP-9) in Kawasaki disease.Clin. Exp. Immunol.,125,340-344.
  27. Thompson, M.M.,Squire, I.B.(2002).Matrix metalloproteinase-9 expression after myocardial infarction: physiological or pathological?.Cardiovasc. Res.,54,495-498.
  28. Zevon, S.S.(1979).Identification of high risk subsets of acute myocardial infarction..Am. J. Cardiol.,44,390-395.
Times Cited
  1. 林至展(2009)。左主冠狀動脈急性阻塞的心電圖變化。中山醫學大學醫學研究所學位論文。2009。1-47。