Hojo Y, Ikeda U, Zhu Y, Okada M, Ueno S, Arakawa H, Fujikawa H, Katsuki T, Shimada K
Department of Cardiology, Jichi Medical School, Tochigi, Japan.
J Am Coll Cardiol. 2000 Mar 15;35(4):968-73. doi: 10.1016/s0735-1097(99)00632-4.
The purpose of this study was to investigate the clinical significance of vascular endothelial growth factor (VEGF) in acute myocardial infarction (AMI). We also examined the involvement of peripheral blood mononuclear cells (PBMCs), which are a possible source of VEGF in AMI.
VEGF is a potent endothelial cell-specific mitogen and could affect the outcome of AMI.
Thirty patients with AMI were used for this study. Serum and PBMCs were isolated from peripheral blood on days 1, 7, 14 and 21 after the onset of AMI. PBMCs were cultured at a density of 5 x 10(6) cells/ml for 24 h. VEGF levels in serum and the culture media were measured by enzyme-linked immunosorbent assay using a specific anti-human VEGF antibody.
Serum VEGF levels elevated gradually after the onset of AMI and reached a peak on day 14. VEGF levels in the culture medium of PBMCs after incubation for 24 h (PBMC-VEGF) were maximally elevated 7 days after the onset. Maximum serum VEGF levels showed significant positive correlations with maximum creatine phosphokinase (CPK) levels (r = +0.70, p < 0.001), but maximum PBMC-VEGF levels did not correlate with maximum CPK levels. Patients showing improvement in left ventricular systolic function during the course of AMI showed significantly higher PBMC-VEGF levels than patients without improvement.
The extent of myocardial damage contributes to the elevation of serum VEGF levels in AMI. VEGF produced by PBMCs may play an important role in the improvement of left ventricular function by promoting angiogenesis and reendothelialization after AMI.
本研究旨在探讨血管内皮生长因子（VEGF）在急性心肌梗死（AMI）中的临床意义。我们还研究了外周血单个核细胞（PBMCs）的作用，其可能是AMI中VEGF的一个来源。
VEGF是一种有效的内皮细胞特异性促有丝分裂原，可能影响AMI的预后。
本研究采用30例AMI患者。在AMI发病后第1、7、14和21天从外周血中分离血清和PBMCs。PBMCs以5×10(6) 细胞/ml的密度培养24小时。使用特异性抗人VEGF抗体通过酶联免疫吸附测定法测量血清和培养基中的VEGF水平。
AMI发病后血清VEGF水平逐渐升高，并在第14天达到峰值。PBMCs孵育24小时后培养基中的VEGF水平（PBMC-VEGF）在发病后7天达到最高。血清VEGF最高水平与肌酸磷酸激酶（CPK）最高水平呈显著正相关（r = +0.70，p < 0.001），但PBMC-VEGF最高水平与CPK最高水平无相关性。在AMI病程中左心室收缩功能改善的患者显示出比未改善患者显著更高的PBMC-VEGF水平。
心肌损伤程度导致AMI中血清VEGF水平升高。PBMCs产生的VEGF可能通过促进AMI后血管生成和再内皮化在左心室功能改善中起重要作用。
