Increased pericardial fluid level of matrix metalloproteinase-9 activity in patients with acute myocardial infarction possible role in the development of cardiac rupture
Increased pericardial fluid level of matrix metalloproteinase-9 activity in patients with acute myocardial infarction possible role in the development of cardiac rupture
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DOI：
10.1253/circj.70.673
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发表时间：
2006-06-01
影响因子：
3.3
通讯作者：
Okumura, Ken
中科院分区：
文献类型：
--
作者：
Kameda, Kunihiko;Matsunaga, Toshiro;Okumura, Ken
背景 在急性心肌梗死 (AMI) 动物模型中，基质金属蛋白酶 (MMP)-9 的缺失可抑制心脏破裂的发展。本研究旨在阐明心肌MMP-9活性如何与人类AMI和心脏破裂的病理生理学相关。方法和结果测量了28名心绞痛患者（AP组）和16名患者的心包液中白细胞介素8（IL-8）、多形核白细胞（PMN）弹性蛋白酶、单核细胞趋化蛋白-1（MCP-1）和MMP活性的水平。接受心脏手术的 AMI 患者（AMI 组）。 AMI组中，5例并发室间隔穿孔（VSP），其余11例未并发（非VSP）。 AMI 组的 IL-8、PMN 弹性蛋白酶、MMP-2 和 MMP-9 活性水平均高于 AP 组。在 AMI 组中，与非 VSP 组相比，VSP 病例中除 MMP-2 活性外的所有水平均进一步升高。各组间 MCP-1 没有显着差异 结论 AMI 中梗死心脏组织中的中性粒细胞活化标志物似乎升高。 MMP-9 活性水平高度升高（可能源自中性粒细胞）和 PMN 弹性蛋白酶，可能与 AMI 中 VSP 或心脏破裂的病理生理学有关。
Background In an animal model of acute myocardial infarction (AMI), deletion of matrix metalloproteinase (MMP)-9 results in suppression of the development of cardiac rupture. The present study sought to clarify how myocardial MMP-9 activity is related to the pathophysiologies of AMI and cardiac rupture in humans.Methods and Results Levels of interleukin-8 (IL-8), po ymorphonuclear leukocyte (PMN) elastase, rnonocyte chemotactic protein-1 (MCP-1) and MMP activity were measured in the pericardial fluid obtained from 28 patients with angina pectoris (AP group) and 16 patients with AMI (AMI group) undergoing cardiac surgery. In the AMI group, 5 were complicated with ventricular septal perforation (VSP) and the remaining 11 were not (non-VSP). Levels of IL-8, PMN elastase, MMP-2 and MMP-9 activity were all higher in the AMI group than in the AP group. In the AMI group, all levels other than MMP-2 activity were further elevated in cases with VSP compared with those in the non-VSP group. There was no significant difference in MCP-1 among the groupsConclusions Markers of neutrophil activation in the infarcted cardiac tissue seem to be elevated in AMI. Highly elevated levels of MMP-9 activity, which may be derived from neutrophils, and PMN elastase may be related to the pathophysiology of VSP or cardiac rupture in AMI.