| Objective:Matrix metalloproteinases-9(MMP-9)and tissue inhibitors of metalloproteinase-1(TIMP-1)play important roles in the synthesis and degradation of extracellular matrix,while the changes of the level or proportion can cause ventricular remodeling.The purpose of this study is to observe the levels of MMP-9 and TIMP-1 in children with ventricular septal defectm(VSD)before and after interventional treatment,combined with the state of cardiac structure and functional measured by cardiac echocardiography,to investigate the relationship between those and ventricular remodeling.Methods:We studied 33 children as treatment group in the diagnosis of left to right shunt VSD by echocardiography,who accepted standard successfully interventional therapy from January 2016 to September 2016 in the first hospital of Hebei Medical University.The children ranged from 3 to 7years old(4.70±1.40 years),including 18 boys and 15 girls.20 healthy children were selected as control group in our hospital in the same period,including 11 boys and 9 girls,ranged from 3 to 7 years old(4.82±1.31 years).All clinical datas were collected.The levels of MMP-9 TIMP-1 were measured in treatment group before interventional therapy,24 hours,5days,1 months,3months and 6months after the interventional therapy.Echocardiography were performed on the treatment group before the procedure,5 days,1months,3months and 6 months after the procedure.The parameters of heart function include: right ventricle transverse diameter(RVTD),right atrial transverse diameter(RATD),left atrial anteroposterior diameter(LAAD),left ventricular end systolic diameter(LVESD),left ventricular end diastolic diameter(LVEDD),left ventricular end diastolic volume(LVEDV),left ventricular endsystolic volume(LVESV),stroke volume(SV),left ventricular ejection fraction(LVEF).The heart rate,blood pressure,heart murmur,the presence of arrhythmia were observed in children before interventional therapy,24 hours,5days,1 months,3 months and 6 months after the interventional therapy.Statistical analysis: statistical analysis was performed by SPSS21.0 software.Results:1 There was no significant difference between the treatment group and the control group in the parameters of gender,age and weight index;2 Changes of the levels of MMP-9 and TIMP-1: the levels of both before and after interventional treatment were higher than those in the control group.The levels of MMP-9 TIMP-1 decreased gradually after intervention,and the most obvious decrease were observed on the 5 day after intervention.There was a decreasing trend,but with no significant difference in 6 months compared with the 3 months after intervention,while there were no difference between the control group and the treatment group after intervention for 6months;3 Change of MMP-9/TIMP-1 ratio: There was no significant difference in MMP-9/TIMP-1 ratio compared with the control group no mater before and after interventional treatment;4 Changes of the parameters of atrioventricular structure and cardiac function: The parameters of RVTD,LAAD,LVEDD,LVESD,LVEDV,LVESV,SV were decreased gradually before interventional therapy,24 hours,5 days,1 months,3 months and 6 months after the interventional therapy.However,RATD and LVEF were not significantly different compared with those before operation;5 The relation between the levels of MMP-9 TIMP-1 and cardiac structure and function: The levels of MMP-9,TIMP-1 were correlated with RVTD,LAAD,LVEDD,LVESD,LVEDV,LVESV,SV.But there was no correlation with the levels of MMP-9 TIMP-1 and RATD,LVEF.The correlation coefficient between MMP-9 and TIMP-1 was 0.870,and the difference was significantly.Conclusions: The levels of serum MMP-9,TIMP-1 can effectively reflect the changes of ventricular volume load and ventricular structure,while those can assess ventricular remodeling and long-term efficacy for children with VSD after transcatheter closure. |
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