Shimony Avi, Zahger Doron, Gilutz Harel, Goldstein Hagit, Orlov Gennady, Merkin Miri, Shalev Aryeh, Ilia Reuben, Douvdevani Amos
Department of Cardiology, Soroka University Medical Center, Ben Gurion University of the Negev, Beer Sheva, Israel.
Acute Card Care. 2010 Sep;12(3):109-11. doi: 10.3109/17482941.2010.513732.
High levels of circulating cell free DNA (CFD) have been associated with poor prognosis in various diseases. Data pertaining to CFD in acute myocardial infarction (MI) are scarce. The available data have been obtained by either electrophoresis or polymerase chain reaction. We evaluated a novel method for the detection of CFD in patients with ST elevation myocardial infarction (STEMI) and examined its correlation with established markers of necrosis and ventricular function.
Serum concentrations of CFD, troponin-T and creatine kinase (CK) were measured simultaneously in 16 randomly selected acute STEMI patients upon admission and at three more time points. 47 healthy subjects served as a control group. CFD was quantified by a novel rapid fluorometric assay. Ejection fraction (EF) was assessed by echocardiography.
Peak CFD levels were significantly higher in patients compared with controls (P = 0.001) and correlated with peak levels of CK and troponin-T (R = 0.79, P <0.001); R = 0.65, P = 0.006, respectively). Peak CFD levels tended to be associated with lower EF (P = 0.075).
With this method, CFD levels correlated with the levels of established markers of myocardial necrosis but not with EF. The kinetic pattern of CFD release after STEMI and its prognostic value require further investigation.
循环游离DNA（CFD）水平升高与多种疾病的不良预后相关。关于急性心肌梗死（MI）中CFD的数据很少。现有的数据是通过电泳或聚合酶链反应获得的。我们评估了一种检测ST段抬高型心肌梗死（STEMI）患者CFD的新方法，并研究了其与已确立的坏死标志物和心室功能的相关性。
在16例随机选择的急性STEMI患者入院时及另外三个时间点同时测量血清CFD、肌钙蛋白T和肌酸激酶（CK）浓度。47名健康受试者作为对照组。通过一种新的快速荧光测定法对CFD进行定量。通过超声心动图评估射血分数（EF）。
患者CFD峰值水平显著高于对照组（P = 0.001），且与CK和肌钙蛋白T的峰值水平相关（R = 0.79，P <0.001；R = 0.65，P = 0.006）。CFD峰值水平倾向于与较低的EF相关（P = 0.075）。
用这种方法，CFD水平与已确立的心肌坏死标志物水平相关，但与EF无关。STEMI后CFD释放的动力学模式及其预后价值需要进一步研究。
