Serum Matrix Metalloproteinase And C-reaction Protein With Chronic Congestive Heart Failure, Effect Of Drug On Them

Objective: Serum MMP-9 and CRP were measured to investigate the change of MMP-9 and CRP in patients with chronic congestive heart failure, the relationship of MMP-9 and the severity of symptoms in patients with chronic congestive heart failure, the change of MMP-9 in different type of CHF and the correlation between MMP-9 and CRR Discussed how Atorvastatin influence serum MMP-9 in patients with chronic CHF.Method: This study was carried out in 90 patients admitted to hospital with the primary diagnosis of chronic CHF. Of these, 27 patients were chronic CHF with NYHA functionⅡ(groupⅡ), 35 were chronic CHF with NYHA function classⅢ(groupⅢ), 28 were chronic CHF with NYHA function iV(groupⅣ), 30 healthy hospital staffs were recruited as normal controls(groupⅠ). Venous blood work was performed in the first morning after hospital admission. Each patient was measured the levels of serum MMP-9 and CRP. Compared the MMP-9 and CRP levels among those study groups. Analyzed the correlation of MMP-9 and CRP. At the same time, 90 cases were divided randomly into two groups: the routine therapy group(n=46), which were treated with routine therapy, and the treatment group(n=44), which received Atorvastatin 20mg qd for 4 weeks on the base of the routine therapy group treatment. The levels of serum MMP-9 before and after treatment were measured and analyzed. Left ventricular ejection fraction(LVEF), parameters of left ventricular diastolic function(E/A ratio) were measured with echocardiograph. Diagnosed LVEF＞50% and E/A＜1 as diastolic heart failure, LVEF＜50% as systolic heart failure. Compared the MMP-9 levels of different type of heart failure.Results: 1,Compared with the normal controls(136.21±35.62ng/ml,3.88±1.82mg/l),the levels of serum MMP-9 and CRP were significantly higher in patients with chronic CHF(463.24±132.41ng/ml, 19.72±11.23mg/l,P＜0.05). 2,The levels of MMP-9 and CRP were parallel with the classification of NYHA for heart dysfunction. 3,The levels of serum MMP-9 was positively correlated with CRP in chronic CHF patients(r=0.71). 4,The levels of MMP-9 was more increased in patients with systolic heart failure(553.73±162.40ng/ml) than that of diastolic heart failure(439.41±138.22ng/ml, P＜0.05). 5,Compared with the routine therapy group(421.37±98.45ng/ml), the levels of serum MMP-9 significantly decreased in the treatment group(334.24±106.52ng/ml, P＜0.05), after 4 weeks of therapy.Conclusion: The levels of serum MMP-9 and CRP significantly increased in chronic CHF patients. The higher degree of CHF, the higher serum MMP-9 and CRP levels. The levels of serum MMP-9 was positively correlated with CRP in chronic CHF patients. The levels of serum MMP-9 was higher in patients with systolic heart failure than that of diastolic heart failure. Treatment with Atorvastatin can decrease the levels of serum MMP-9. It suggests that MMP-9 and CRP can be potential noninvasive markers of the chronic CHF, statin may have therapeutic benefits in chronic CHF.