Iwama Hajime, Uemura Shiro, Naya Noriyuki, Imagawa Kei-ichi, Takemoto Yasuhiro, Asai Osamu, Onoue Kenji, Okayama Satoshi, Somekawa Satoshi, Kida Yoshitomi, Takeda Yukiji, Nakatani Kimihiko, Takaoka Minoru, Kawata Hiroyuki, Horii Manabu, Nakajima Tamio, Doi Naofumi, Saito Yoshihiko
First Department of Medicine, Nara Medical University, Kashihara, Nara, Japan.
J Am Coll Cardiol. 2006 Apr 18;47(8):1559-67. doi: 10.1016/j.jacc.2005.11.064. Epub 2006 Mar 27.
Our aim was to investigate cardiac expression of placental growth factor (PlGF) and its clinical significance in patients with acute myocardial infarction (AMI).
Placental growth factor is known to stimulate wound healing by activating mononuclear cells and inducing angiogenesis. The clinical significance of PlGF in AMI is not yet known.
Fifty-five AMI patients and 43 control subjects participated in the study. Peripheral blood sampling was performed on days 1, 3, and 7 after AMI. Blood was also sampled from the coronary artery (CAos) and the coronary sinus (CS), before and after acute coronary recanalization. Cardiac expression of PlGF was analyzed in a mouse AMI model.
In AMI patients, peripheral plasma PlGF levels on day 3 were significantly higher than in control subjects. Plasma PlGF levels just after recanalization were significantly higher in the CS than the CAos, which indicates cardiac production and release of PlGF. Peripheral plasma levels of PlGF on day 3 were negatively correlated with the acute phase left ventricular ejection fraction (LVEF), positively correlated with both acute phase peak peripheral monocyte counts and chronic phase changes in LVEF. Placental growth factor messenger ribonucleic acid expression was 26.6-fold greater in a mouse AMI model than in sham-operated mice, and PlGF was expressed mainly in endothelial cells within the infarct region.
Placental growth factor is rapidly produced in infarct myocardium, especially by endothelial cells during the acute phase of myocardial infarction. Placental growth factor might be over-expressed to compensate the acute ischemic damage, and appears to then act to improve LVEF during the chronic phase.
我们的目的是研究胎盘生长因子（PlGF）在急性心肌梗死（AMI）患者中的心脏表达及其临床意义。
已知胎盘生长因子通过激活单核细胞和诱导血管生成来刺激伤口愈合。PlGF在AMI中的临床意义尚不清楚。
55例AMI患者和43例对照受试者参与了该研究。在AMI后第1、3和7天进行外周血采样。在急性冠状动脉再通前后，还从冠状动脉（CAos）和冠状窦（CS）采集血液。在小鼠AMI模型中分析PlGF的心脏表达。
在AMI患者中，第3天外周血浆PlGF水平显著高于对照受试者。再通后即刻CS中的血浆PlGF水平显著高于CAos，这表明心脏产生并释放PlGF。第3天外周血浆PlGF水平与急性期左心室射血分数（LVEF）呈负相关，与急性期外周单核细胞峰值计数和LVEF的慢性期变化均呈正相关。在小鼠AMI模型中，胎盘生长因子信使核糖核酸表达比假手术小鼠高26.6倍，且PlGF主要在梗死区域的内皮细胞中表达。
胎盘生长因子在梗死心肌中迅速产生，尤其是在心肌梗死急性期由内皮细胞产生。胎盘生长因子可能过度表达以补偿急性缺血损伤，然后似乎在慢性期发挥作用以改善LVEF。
