The Clinical Application Of Serum MMP-9, Hs-CRP, UA And Ip(a) Level In Chronic Heart Failure Patients

Objective To investigate the change of serum MMP-9, high sensitive C-reactive protein(hs-CRP), lipoprotein (a) (Lp (a)), serum uric acid (UA) in the chronic heart failure(CHF)patients, and the correlation with the severity of failure. Observe cardiac function changeapplying ACEI joint beta blockers in chronic heart failure patients.Methods Selected 98 patients with chronic heart failure [1] (by NYHA functional class: II Level30 cases, III grade 46 cases and IV grade 22 cases) and 21 healthy subjects as normal controlgroup, by immunization project Turbidity measured hs-CRP, Lp (a); enzyme-linked immunosorbentassay measured serum MMP-9; Oxidase method measured UA; color Doppler echocardiographyfor le ft ventricular ejection fraction (LVEF) and left ventricular end diastolicdiameter (LVEDD) determination. Using statistical data SPSS13.0 package, between the twogroups, compares the t test between groups, compares the variance analysis on LSD - t-test andrelevant analysis; To P < 0.05 for difference have statistical significance.Results (1) serum MMP-9, hs-CRP, lp (a), UA level in CHF patients were significantly higherthan the control group (P <0.01). (2) serum MMP-9, hs-CRP and UA, Lp (a) levels in thedifferent functional class of CHF patients higher than the control group (P <0.01 or <0.05); theworse heart function, the higher MMP-9, hs–CRP, UA level and the greater the left ventriculardiastolic diameter, the lower left ventricular ejection fraction ,the difference between the groupswas statistically significant (P <0.05); Lp (a) level was also increasing with the deterioration ofcardiac function, However, the difference was no significant between the heart function class IIIand class IV (P> 0.05). (3) serum MMP-9, hs-CRP, UA level was no significant difference in theCHF patients with the same classification but different causes (p> 0.05); the difference of Lp (a)level was no significance in the class II ,but in the class III~ IV , Lp (a) level with coronary heartdisease was higher than high blood pressure group and expansionary cardiomyopathy group, thedifference was statistically significant (P <0.05).(4) serum MMP-9, uric acid levels have goodcorrelation with LVEF .serum MMP-9 and hs-CRP also have a good correlation with LVEDD.serum MMP-9 ,Uric acid and Lp(a) have a good correlation with hs– CRP.via Spearman rankcorrelation analysis, Serum MMP - 9, hs - CRP, uric acid, Lp (a) level and NYHA grading have apositive correlation. (5) the application of ACEI joint beta blockers in Chronic hf patients is toimprove cardiac function than before (P < 0.05), and the longer application ,the better improvement.Conclusion 1. Serum MMP - 9, hs - CRP, UA level will play an important role for the severityof chronic heart failure patients and the prognosis.2. The inflammation reaction participate inchronic heart failure process of development, and thus aggravate myocardial reconstruction 3.Chronic heart failure patients with cardiac structure and functional changes are closely relatedwith immune metabolic abnormalities (such as lipoprotein (a) and uric acid etc), elevatedinflammatory factor and matrix metalloproteinases activation. 4. in no contraindications,long-term using ACEI joint beta blockers in chronic heart failure patients has an important roleto improve cardiac function.