Effect of Enalapril and Valsartan on Left Ventricular Remodeling and MMP-9 Level in Patients with Chronic Heart Failure

Objective To evaluate the effects of enalapril and(or) valsartan on the regulation of extracellular matrix degradation and the improvement of myocardial remodeling in patients with chronic heart failure (CHF).Methods Totally 90 CHF patients were equally randomized into 3 groups:enalapril group (10mg/d of enalapril for 8 weeks),valsartan group (80mg/d of valsartan for 8 weeks),and combined group (10mg/d of enalapril and 80mg/d of valsartan,for 8 weeks).The serum MMP-9 levels and echocardiographic indicators including left ventricular end-systolic volume (LVESV),left ventricular end-diastolic volume (LVEDV),and left ventricular ejection fraction (LVEF) were measured before and after treatment.Results Serum MMP-9 level and echocardiographic parameters were significantly different among three groups (P0.05).In addition,serum MMP-9 level was negatively correlated with LVEF (r=-0.355,P=0.001) and positively correlated with LVEDV (r=0.346,P=0.001).In each group,serum MMP-9 level,LVESV,and LVEDV significantly decreased and LVEF significantly increased after treatment (P0.05).Also,serum MMP-9 level,LVESV,and LVEDV in combined group were significantly lower than those in enalapril group and valsartan group;on the contrary,LVEF in combined group was significantly higher than those in enalapril group and valsartan group (P0.05).However,no such difference was noted between enalapril group and valsartan group (P0.05).Conclusion Enalapril combined with valsartan is remarkably superior than enalapril or valsartan alone in treating patients with CHF.The combined therapy can effectively reduce the MMP-9 level,adjust the levels of MMPs,and thus improve myocardial remodeling.