RESUMO
The aim of the study was to assess the occurrence of classic risk factors in the study group of patients with heart failure and to link them with the transcriptional activity of the examined genes: metalloproteinase 9 (MMP-9) and the tissue inhibitor of metalloproteinases 1 (TIMP-1). A total of 150 (100%) patients qualified for the study, including 80 (53.33%) patients with heart failure in the course of coronary artery disease, 40 (26.67%) with coronary artery disease without heart failure, and 30 (20.00%) in whom the presence of atherosclerotic changes in the coronary arteries was excluded. The material for molecular tests was peripheral blood collected from patients within the first 24 h of hospitalisation. A quantitative analysis of transcriptional activity was performed using the RT-qPCR technique. The most common classic risk factors among the patients in the study group were arterial hypertension (117; 78.00%) and overweight/obesity (102; 68%). In the group of patients with coronary artery disease and heart failure burdened with overweight/obesity, a significantly higher transcriptional activity of the metalloproteinase 9 (MMP-9) gene was found in comparison to patients who were not burdened with this risk factor. The analysis also showed the statistically significant higher transcriptional activity of the metalloproteinase 9 (MMP-9) gene in a group of patients with coronary artery disease and heart failure who smoked. The examined patients with heart failure due to myocardial ischemia were burdened with numerous cardiovascular risk factors, the most common of which were arterial hypertension, obesity/overweight, and hypercholesterolemia. A significant increase in the transcriptional activity of the metalloproteinase 9 (MMP-9) gene in the presence of risk factors (male sex, overweight/obesity, smoking) indicates another pathomechanism of their action and participation in the development and progression of heart failure during myocardial ischemia. There is a need for systematic information and educational activities promoting a healthy lifestyle with the elimination of modifiable risk factors for cardiovascular diseases.
RESUMO
The most common cause of heart failure (HF) is coronary artery disease (CAD). The aim of this study was to evaluate the transcriptional activity of the metalloproteinase 9 (MMP-9) and tissue metalloproteinase inhibitor 1 (TIMP-1) genes in a study group of patients with HF due to CAD and in the control group, as well as assess the transcriptional activity of the examined genes, taking into account the number of affected coronary arteries and the severity of heart failure. The study group consisted of a total of 150 (100%) patients. The material for the study was peripheral blood, and molecular tests were performed using the quantitative QRT-PCR technique. The transcriptional activity of the MMP-9 gene was significantly higher in the group of patients with CAD and HF. It was also significantly higher with the progression of heart failure. TIMP-1 gene transcriptional activity was significantly lower with the advancement of heart failure. The transcriptional activity of the MMP-9 and TIMP-1 genes differentiated the examined patients. The severity of HF, and a significant increase in the QRT-PCR transcriptional activity of the MMP-9 gene with a simultaneous decrease in the activity of the TIMP-1 gene, makes them useful diagnostic and prognostic markers in clinical practice.
RESUMO
BACKGROUND: Heart failure (HF) is a major cause of mortality in developed countries. Its formation is associated with a change in the transcriptional activity of many genes. The aim of the study was to select, from the group of genes related to coronary atherosclerosis and heart failure, genes differentiating patients with coronary heart disease and heart failure on the basis of myocardial ischemia from healthy people, and then genes differentiating patients with various stages of heart failure. METHODS: The study was carried out using the oligonucleotide microarray technique HG-U133A (Affymetrix, Santa Clara, CA, USA). Cluster analysis showed a homogeneous division of the study group into patients with heart failure and healthy patients with excluded coronary artery disease and patients with heart failure depending on the size of the left ventricle ejection fraction. RESULTS: The study showed that genes differentiating the group of patients from healthy people were: TGF-ß1, TIMP-1 and MMP-9. The analysis also showed that genes differentiated patients with advanced heart failure in the course of coronary disease and left ventricular ejection fraction (LVEF) 20% and patients from the group with 40% LVEF were MMP-9 and TIMP-1. CONCLUSIONS: Extracting from the group of genes related to coronary atherosclerosis and cardiac failure: MMP-9, TGF-ß1 and TIMP-1 differentiating patients with heart failure on the basis of myocardial ischemia in varying degrees of severity from healthy people may indicate their significant contribution to disease development. Also increased expression of the metalloproteinase gene 9 (MMP-9) with a simultaneous decrease in the expression of its tissue inhibitor 1 (TIMP-1) in the studied group of patients with ischemic heart failure differing in left ventricular ejection fraction LVEF makes them the markers of progression in failure.