Association among Soluble Tumor Necrosis Factor Receptor I, Matrix Metalloproteinase-9, Procollagen C-terminal Propeptide type I, and N-Terminal proBrain Natriuretic Peptide in Heart Failure

BACKGROUND: Heart failure (HF) is associated with an increased expression of proinflammatory cytokines, especially soluble tumor necrosis factor receptor I (sTNFR I), but the underlying mechanism to the relationship between sTNFR I activation and the progression of HF is not yet fully understood. This study aims to see the association between sTNFR I, MMP-9, PICP, and NT-proBNP in the progression of HF. METHODS: This was a cross sectional study which recruited 45 subjects with HF confirmed by echocardiography and NT-proBNP. Concentration sTNFR I, MMP-9, and PICP were measured using ELISA method, whereas NT-proBNP concentration was measured using ECLIA method. Univariate linear regression analysis, path analysis and General Linear Model were used to determine which parameters played the most significant role in HF. RESULTS: Results of the univariate linear regression and path analysis showed there was a linear relationship between sTNFR I with MMP-9, with R square of 25.8% (p=0.00; r=0.508), R square sTNFRI and MMP-9 with PICP was 14.4% (p=0.038; r=0.379) and R square MMP-9 and PICP with NT-proBNP was 39.6% (p=0.00; r=0.629). From the General Linear Model we found that the important predictor for HF was through MMP-9 and PICP. CONCLUSION: sTNFR I as a proinflammatory factor is one of the factors involved in the heart failure as seen by NT-proBNP through activation of brosis (PICP) and remodeling factor (MMP-9).