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To study the level of activity of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-4 (TIMP-4) at different classes of heart failure.The study included 38 patients who were on treatment for heart failure. The diagnosis of heart failure was established based on the NYHA classification. The presence of heart failure confirmed by echocardiography with assessment of systolic and diastolic left ventricular (LV) function. In all patients at admission was determined in the serum levels of MMP-9 and TIMP-4 by ELISA using laboratory kits BCM Diagnostics (USA).Thus, the concentration of MMP-9 in the serum of patients with heart failure I, II and III class was increased as compared with the control subjects and averaged 4.51 ± 0.27 ng/ml. The concentration of TIMP-4 in the serum of patients with heart failure I, II and III class was reduced as compared with the control subjects and averaged 0.26 ± 0.04 ng/ml. Concentration in blood of MMP-9 for patients with class II heart failure was 12% higher than the class I, and class III at - 24% higher than on class II heart failure. The concentration of TIMP-4 in patients with class II was 14% lower than the class I, and class III at - 25% lower than class II heart failure.The results of this work have established a pattern of participation of MMP-9 and TIMP-4 in the processes that accompany the restructuring of the extracellular matrix of the heart during remodeling LV, development and progression of heart failure. Therefore, the further task will be to search for drugs and the development of new approaches to the treatment of heart failure from the point of view of the study of pathogenetic mechanisms.