Soeki Takeshi, Tamura Yoshiyuki, Shinohara Hisanori, Sakabe Koichi, Onose Yukiko, Fukuda Nobuo
Department of Cardiology and Clinical Research, National Zentsuji Hospital, Japan.
Circ J. 2002 Nov;66(11):1003-7. doi: 10.1253/circj.66.1003.
Hepatocyte growth factor (HGF) and vascular endothelial growth factor (VEGF) stimulate endothelial cell proliferation and induce angiogenesis, but the timing and significance of their release in patients with acute myocardial infarction (AMI) are unknown in relation to future left ventricular remodeling. Venous blood samples were obtained at admission and up to 3 weeks later in 40 patients with AMI and in 40 age- and sex-matched control subjects. Blood samples were also taken from the coronary sinus (CS) in 20 patients on day 7 following AMI. Left ventricular end-diastolic volume in the subacute (1 week) and chronic (3 months) phases was assessed by left ventriculography to identify the remodeling group (n=15), which was defined as an increase in left ventricular end-diastolic volume index > or =5 ml/m(2) relative to the baseline value. Serum HGF and VEGF concentrations were higher in newly admitted patients with AMI than in the controls (HGF, 0.33 +/-0.09 vs 0.24+/-0.08 ng/ml, p<0.01; VEGF, 92.2+/-43.1 vs 67.2+/-29.8 pg/ml, p<0.01), peaking on day 7 (HGF, 0.41+/-0.12; VEGF, 161.7+/-76.9), and gradually decreasing between days 14 and 21. The HGF concentration in the CS did not differ from the concentration in the periphery, but the VEGF concentration was significantly more abundant in the CS than in the peripheral sample on day 7 (p<0.05). The serum HGF concentration on day 7 was higher in the remodeling group than in the nonremodeling group (0.47 +/-0.13 vs 0.36+/-0.09 ng/ml, p<0.01), but there was no difference between the groups on admission, day 14 and day 21. The serum VEGF concentration did not differ between the remodeling and nonremodeling groups at any time. Thus, the serum HGF concentration on day 7 after AMI is mostly from noncardiac sources and predicts left ventricular remodeling.
肝细胞生长因子（HGF）和血管内皮生长因子（VEGF）可刺激内皮细胞增殖并诱导血管生成，但在急性心肌梗死（AMI）患者中，它们释放的时间及意义与未来左心室重构的关系尚不清楚。对40例AMI患者及40例年龄和性别匹配的对照者在入院时及之后长达3周内采集静脉血样本。还在20例AMI患者发病后第7天从冠状窦（CS）采集血样。通过左心室造影评估亚急性期（1周）和慢性期（3个月）的左心室舒张末期容积，以确定重构组（n = 15），重构组定义为左心室舒张末期容积指数相对于基线值增加≥5 ml/m²。AMI新入院患者血清HGF和VEGF浓度高于对照组（HGF，0.33±0.09 vs 0.24±0.08 ng/ml，p<0.01；VEGF，92.2±43.1 vs 67.2±29.8 pg/ml，p<0.01），在第7天达到峰值（HGF，0.41±0.12；VEGF，161.7±76.9），并在第14天至21天逐渐下降。CS中的HGF浓度与外周血浓度无差异，但在第7天CS中的VEGF浓度明显高于外周血样本（p<0.05）。重构组第7天的血清HGF浓度高于非重构组（0.47±0.13 vs 0.36±0.09 ng/ml，p<0.01），但入院时、第14天和第21天两组之间无差异。重构组和非重构组在任何时间的血清VEGF浓度均无差异。因此，AMI后第7天的血清HGF浓度主要来自非心脏来源，并可预测左心室重构。
