The Level Of The Serum MMP-9 In Children Congenital Heart Disease And The Correlation Between The MMP-9 And Myocardial Remodeling

[Objective] To investigate the level of serum matrix metalloproteinase-9 (MMP-9) in children with left to right shunt congenital heart disease(CHD),analyze the correlation between the serum MMP-9 and cardiac function,ventricular volume load,pulmonary artery pressure and heart remodeling.[Method] 1.62 cases of left to right shunt congenital heart disease included ventricular septal defect,atrial septal defect and patent ductus arteriosus in hospital were enrolled from the patients in the Cardiology Dept. of Tianjin Children' s hospital and diagnosed by color Doppler ultrasound.20 cases of control group which had normal blood Rt.,ECG and X-ray check and had no deviation in the age and sex were selected from the patients in the prevent surgery.2.We adopted the ELISA method to measure the content of serum MMP-9 in the patients of the contrast group and the patient group.The patient group was divided into three groups,which were ventricular septal defect group,atrial septal defect group and patent ductus arteriosus group.We divided the patient group into two groups,which were named large shunt group and small shunt group according to the ratio of pulmo and systemic circulation.We classified the patient group into two groups,which were named heart failure group and non-heart failure group and divided the patient group into two groups,which were named pulmonary artery hypertension group and non-pulmonary artery hypertension group according to the mean pressure of pulmonary artery.3.We applied the Philips Sonos 5500 type Echocardiogram to measure the left atrium diameter(LAD),left ventricular end systolic inner diameter(LVESD),left ventricular end diastolic inner diameter(LVEDD),end-systolic wall thickness of the left ventricular , left ventricular end diastolic volume(LVEDV) and so on,calculated left atrium diameter index(LADI),left ventricular end diastolic inner diameter index(LVEDDI), left ventricular end diastolic volume index (LVEDVI),LVFS,LVEF,CI,mean pulmonary artery pressure,ratio of pulmo and systemic circulation(Qp/Qs),left ventricular end-systolic wall stress(LVESWS) and left ventricular mass index(LVmassI).4.We analysis all the datum with SPSS11.5 For Windows.[Result] 1.The serum MMP-9 in patient group is higher than the contrast group (p<0.01);the level of MMP-9 in the different types of congenital heart disease are significantly higher than the contrast group respectively(p<0.01).The serum MMP-9 is higher in heart failure group than in non-heart failure group(p<0.01),so is that in large shunt group than in small shunt group(p<0.01) and it is higher in pulmonary artery hypertension group than in non-pulmonary artery hypertension group(p<0.05).2. The left atrial diameter index, left ventricular end diastolic inner diameter index, left ventricular end diastolic volume index, left ventricular mass index of heart failure group are larger than those of non-heart failure group(p<0.01).The cardiac output index of heart failure group is higher than that of non-heart failure group(p<0.05).There have no statistical significantly difference in LVFS,LVEF and left ventricular end-systolic wall stress between the heart failure group and non-heart failure group(p>0.05).3.There is one kind of positive rank correlation between the serum level of MMP-9 and left atrial diameter index and left ventricular end diastolic diameter index(p<0.01).[Conclusion] 1 .The serum MMP-9 in children with left to right shunt congenital heart disease is increased significantly.It can be done as an objective index in auxiliary diagnosis and appraisal the severity of the left to right shunt.2.The serum MMP-9 in heart failure group is higher than that of non-heart failure.The serum MMP-9 may be done as an objective parameter in the diagnosis of heart failure.3.The serum MMP-9 is higher in pulmonary artery hypertension group than in non- pulmonary artery hypertension group. The serum MMP-9 may be a biological parameter in discovery of pulmonary artery hypertension earlier.4.There is a positive rank correlation between the serum MMP-9 and left atrial diameter index, left ventricular end diastolic diameter index.Monitor the level of MMP-9 will help us find adverse myocardial remodeling earlier and begin treatment immediately to prevent developing heart failure.