. Role of matrix metalloproteinase-9 in endothelial apoptosis in chronic heart failure in mice. J Appl Physiol 99: [2398][2399][2400][2401][2402][2403][2404][2405] 2005. First published August 4, 2005; doi:10.1152/japplphysiol.00442.2005.-Accumulation of oxidized extracellular matrix between endothelium and muscle is an important risk factor in the endothelium-myocytes uncoupling in congestive heart failure. Although ventricular remodeling is accompanied by increased matrix metalloproteinase (MMP)-9 activity, it is unclear whether MMP-9 plays a role in endothelial apoptosis in chronic volume overload congestive heart failure. We tested the hypothesis that, in chronic volume overload, myocardial dysfunction involves endocardial endothelial (EE) apoptosis in response to MMP-9 activation, extracellular matrix accumulation, and endotheliummyocytes uncoupling. Arteriovenous fistula (AVF) was created in control (FVB/NJ) and MMP-9 knockout (MMP-9KO; FVB.Cg-MMP9 tm1Tvu /J) mice. Sham surgery was used as control. Mice were grouped as follows: wild type, n ϭ 3 (sham control); MMP-9KO, n ϭ 3 (sham); AVF, n ϭ 3; and MMP-9KO ϩ AVF (n ϭ 3). Heart function was analyzed by M-mode and Doppler echocardiography, and with a pressure-tipped Millar catheter placed in the left ventricle of anesthetized mice 8 wk after AVF. Apoptosis was detected by measuring caspase-3, transferase-mediated dUTP nick-end labeling (TUNEL), and CD-31 by immunolabeling. Protease-activated receptors-1, connexin-43, and a disintegrin and MMP-12 (ADAM-12) expression were measured by Western blot analyses. MMP-2 and MMP-9 expression were measured by quantitative RT-PCR. Compared with control, AVF caused an increase in left ventricle end diastolic pressure and decrease in ϪdP/dt. In contrast, in the MMP-9KO ϩ AVF group, these variables were changed toward control levels. Increased EE apoptosis (caspase-3 activation and TUNEL/ CD-31 colabeling) in AVF mice was prevented in the MMP-9KO ϩ AVF group. Protease-activated receptor-1, connexin-43, and ADAM-12 were induced in AVF. MMP-9 gene ablation ameliorated the induction. The results suggest that impaired cardiac function in volume overload is associated with EE apoptosis, cardiac remodeling, and endothelium-myocytes uncoupling in response to MMP-9 activation. arteriovenous fistula; endocardial dysfunction; extracellular matrix remodeling; terminal deoxynucleotidyl nick-end labeling; connexin-43; protease-activated receptors-1; a disintegrin and metalloproteinase-12; congestive heart failure MYOCARDIAL REMODELING IN congestive heart failure (CHF) is associated with accumulation of extracellular matrix (ECM) between endothelial and muscle cells (21) and is one of the most important factors of endocardial endothelial dysfunction (8,14). Previous studies showed that morphological changes in myocardium are associated with increased expression and activity of matrix metalloproteinases (MMPs) (6, 18). MMPs degrade interstitial collagen and elastin, but the more collagen is degraded, the more that is synthesized. Consequ...