Circulating matrix metalloproteinases and tissue inhibitors of metalloproteinases levels in pediatric patients with congenital heart disease: Relationship to cardiac functions

Abstract

Objective: The pathological effects of matrix metalloproteinases and their tissue inhibitors in cardiovascular diseases are of considerable inter-est. In our study, we aimed to determine and evaluate the potential significance of circulating matrix metalloproteinases-2 and 9, tissue inhibi-tors of matrix metalloproteinases-1 and 2 levels in four patient subgroup of pediatric cardiology field and expose pathophysiologic differencesbetween these groups.Methods: Eighty-seven patients with the diagnosis of congenital heart disease and 47 healthy controls were enrolled in the study. The studygroup was stratified to 4 subgroups; 14 patients with right ventricular volume overload, 30 patients with left ventricular volume overload, 19patients with left to right shunt who developed pulmonary hypertension and 24 patients with cyanotic congenital heart disease. For evaluationof the relationships between serum matrix metalloproteinases and their tissue inhibitors levels with cardiac structures and functions; completeblood count, arterial oxygen saturation, detailed echocardiographic measurements (including tissue Doppler) in all patients and hemodynamicparameters of the patients who went to cardiac catheterization were recorded. Serum matrix metalloproteinase levels were determined byELISA test. Statistical evaluations were performed with SPSS 16.0. For parameters showing normal distribution, comparisons were made witht-test and ANOVA test. However, for parameters without normal distribution, groups were compared with Mann-Whitney U test and Kruskal-Wallis test.Results: We demonstrated that serum tissue inhibitors of matrix metalloproteinases-1 levels of patients with pulmonary hypertension second-ary to congenital heart diseases were significantly higher than the patients with left to right shunt without pulmonary hypertension and controls(p