Changes And Its Significance Of Serum P-ICP, P-â…¢-NP, IGF-1 And Collagens, Matrix Metalloproteinases And Their Inhibitors In Myocardial Tissue Of Children With Tetralogy Of Fallot During Perioperative Period

Objective: To explore the changes and its significance of serum P-ICP, P-â…¢-NP, IGF-1 and collagens,matrix metalloproteinases and their inhibitors in myocardial tissue of children with tetralogy of Fallot (TOF) during perioperative period.Methods: The serum concentrations of P-ICP, P-â…¢-NP and IGF-1 in 20 children with TOF and 11 children with ventricular septal defect (VSD) were measured by Enzyme-Linked immunosorbant assay ( ELISA) test before and after operation, respectively. The expression of collagens, MMP-1, MMP-2, MMP-9, TIMP-1 and TIMP-2 in the myocardial tissue was assessed by immunohistochemistry. Several parameters of right ventricular (RV) anatomy and diastolic function were determined before operation by echocardiography and compared to those of 21 health children.Results: The serum levels of P-ICP and P-â…¢-NP in TOF group were significantly higher than those of VSD group and control group (P<0.01) ,while the serum levels of IGF-1 in TOF group and VSD group were significantly higher than those of control group before operation (P<0.01) ; The serum levels of P-ICP and P-â…¢-NP in TOF group and the serum levels of P-â…¢-NP in VSD group after operation were significantly higher than those of before operation (P<0.01) , while there was no significantly changes in the serum levels of IGF-1 in TOF group , IGF-land P-ICP in VSD group before operation and after operation (P>0.05); The TIMP-1 of RV in TOF group were significantly increased compared to those of VSD group, while MMP-1, MMP-9 were significantly lower than those of VSD group. The CVF and PVCA of RV in TOF group were significantly increased compared to those of VSD group; The RVAW, RVD and IVST of RV in TOF group were higher than those of VSD group(P<0.01) and control group ( P<0.001); and the V_e/V_a and VTI_e/VTI_a of RV in TOF group were lower than those of VSD group and control group (P<0.001). The serum levels of P-ICP, P-III-NP and the CVF, PVCA and TIMP-1 of RV in TOF group were negatively related to V_e/V_a and VTI_e/VTI_a of RV, but were positively related to RVAWT and IVST. However, MMP-1 were positively related to V_e/V_a and VTI_e/VTI_a of RV, and negatively related to RVAWT and IVST. The serum level of IGF-1 were positively related to that of P-ICP and P-â…¢-NP (P<0.01 and P<0.001). The serum levels of P-ICP and P-â…¢-NP in TOF group were positively related to the age (P<0.01 and P<0.001).Conclusions: The increased serum P-ICP and P-â…¢-NP levels and the increased cardiac...