Kolosov E. The role of matrix metalloproteinases in forming of hypertensive heart.

Object of the study: arterial hypertension. Purpose of the study: optimisation and improvement of extracellular myocardial matrix remodeling diagnostics on the basis of matrix metalloproteinase-1 system investigations using distance markers of fibrosis determinations Methods of the investigation: clinical, biochemical, immunoenzyme and instrumental methods were used. Theoretical and practical results: Determination of the model of left ventricular geometrical remodeling recommended for complex assessment of system matrix metalloproteinases-1 functioning and changes into the extracellular myocardial matrix in patients with hypertension. More expressed lowering of matrix metalloproteinase-1 activity and increasing of collagen volume fraction in patients with hypertension strongly correlates with increasing of left ventricular mass index and end-diastolic diameter. The interstitial collagen accumulation into the myocardial extracellular matrix is more considerable in hypertensive patients with left ventricular hypertrophy and accompanying obesity. The antihypertensive drugs, which capable to increase of matrix metalloproteinase-1 activity and decrease of collagen synthesis (ACE inhibitors, angiotensin receptors blockades, aldosterone antagonistes), are pathogenetically substantiate in all patients with hypertension. Novelty: the complex research of matrix metalloproteinase-1 status in patients with different types of left ventricular remodeling was performed for the first time. It is shown that matrix metalloproteinase-1 activity is increased in hypertensive patients, and expression of these changes is relevant to forming of different types of left ventricular geometrical remodeling. It is summarized that level of latent form matrix metalloprpteinase-1 reflects degree of expression of myocardial interstitial fibrosis. The existence of mechanism which prevents progress of cardiomyocytes hypertrophy at the expense of collagen I type degradation was confirmed. Correlation between degree of functional class of chronic heart failure and expression of interstitial collagen deposition into the extracellular myocardial matrix in patients with hypertension was determined. Degree of introduction: the results of the research were introduced into the work of therapy departments of city hospital No. 11 (Kharkiv), city hospital (Balaklea and Bogoduchov, Kharkiv region). 1 patent of Ukraine is received. Sphere of application: medicine, therapy and cardiology departments.