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急性心肌梗死后与梗死面积及左心室重构相关的趋化因子网络

The chemokine network in relation to infarct size and left ventricular remodeling following acute myocardial infarction.

作者信息

Orn Stein, Breland Unni M, Mollnes Tom Eirik, Manhenke Cord, Dickstein Kenneth, Aukrust Pål, Ueland Thor

机构信息

Stavanger University Hospital, Norway.

出版信息

Am J Cardiol. 2009 Nov 1;104(9):1179-83. doi: 10.1016/j.amjcard.2009.06.028. Epub 2009 Sep 16.

DOI:10.1016/j.amjcard.2009.06.028
PMID:19840558
Abstract

Increased circulating chemokines have been reported during acute myocardial infarction and might give prognostic information about future ischemic events. However, data on the chemokine network in relation to infarct size and measures of left ventricular remodeling after successful percutaneous coronary intervention (PCI) are lacking. A total of 42 patients with first-time ST-segment elevation acute myocardial infarction with a single occluded vessel were recruited, and cardiac magnetic resonance was used for serial assessment (2, 7, and 60 days) of infarct size and left ventricular remodeling. The chemokines were analyzed before and after PCI. After PCI, high levels of CCL4, CXCL16, CXCL10, and, in particular, CXCL8 within the first week after PCI correlated positively with the degree of myocardial damage, as reflected by correlations with the maximum troponin T levels and infarct size after 2 months, as assessed by cardiac magnetic resonance, and with impaired myocardial function after 2 months as assessed by cardiac magnetic resonance and neurohormonal methods. In contrast, the plasma levels of CCL3 and CXCL7 during the first week correlated negatively with myocardial dysfunction after 2 months. In conclusion, our findings suggest a role for chemokines in both adaptive and maladaptive responses after myocardial infarction and might support a role for CCL4, CXCL16, CXCL10, and, in particular, CXCL8 in postmyocardial infarction reperfusion and remodeling.

摘要

据报道,急性心肌梗死期间循环趋化因子水平升高,这可能为未来缺血事件提供预后信息。然而,关于成功进行经皮冠状动脉介入治疗(PCI)后趋化因子网络与梗死面积及左心室重构指标之间关系的数据尚缺乏。共招募了42例首次发生单支血管闭塞的ST段抬高型急性心肌梗死患者,并使用心脏磁共振对梗死面积和左心室重构进行系列评估(第2、7和60天)。在PCI前后对趋化因子进行分析。PCI后,PCI后第一周内高水平的CCL4、CXCL16、CXCL10,尤其是CXCL8与心肌损伤程度呈正相关,这通过与最大肌钙蛋白T水平以及2个月后通过心脏磁共振评估的梗死面积的相关性得以体现,同时也与2个月后通过心脏磁共振和神经激素方法评估的心肌功能受损相关。相比之下,第一周内CCL3和CXCL7的血浆水平与2个月后的心肌功能障碍呈负相关。总之,我们的研究结果表明趋化因子在心肌梗死后的适应性和适应性不良反应中均发挥作用,并且可能支持CCL4、CXCL16、CXCL10,尤其是CXCL8在心肌梗死后再灌注和重构中的作用。

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