内皮祖细胞是由心肌缺血还是心肌坏死动员的？一项心脏磁共振研究。
Are endothelial progenitor cells mobilized by myocardial ischemia or myocardial necrosis? A cardiac magnetic resonance study.
机构信息
Department of Cardiovascular Medicine, Catholic University of the Sacred Heart, Largo A. Gemelli, 8, 00168 Rome, Italy.
出版信息
Atherosclerosis. 2011 Jun;216(2):355-8. doi: 10.1016/j.atherosclerosis.2011.02.014. Epub 2011 Feb 17.
BACKGROUND
In ST-elevation myocardial infarction (STEMI) patients, the main stimuli involved in endothelial progenitor cells (EPCs) mobilization are not fully understood. We aimed to assess by cardiac magnetic resonance (CMR) whether the extent of ischemic myocardium (area at risk (AAR)) or of necrotic myocardium (infarct size (IS)) can be correlated to levels of circulating EPCs.
METHODS
Peripheral EPCs were measured in fifteen STEMI patients at 24h after successful primary percutaneous coronary intervention (pPCI). Between two and four days after pPCI all patients underwent CMR assessment of myocardial AAR, IS, myocardial salvage (MS) and microvascular obstruction at late gadolinium enhancement CMR (LG-MVO).
RESULTS
CD34+/KDR+, CD34+/KDR+/CD45dim, CD34+/KDR+/CD45-, EPCs were related to extent of AAR (rho=0.51, p=0.05; rho=0.55, p=0.03; rho=0.72, p=0.002, respectively), while no relationships were detected with IS, MS or LG-MVO.
CONCLUSIONS
Our data show that EPCs were strongly correlated to extent of myocardial AAR, thus suggesting that progenitor cells mobilization in STEMI develops in response to myocardial ischemia and not to myocardial necrosis.
背景
在 ST 段抬高型心肌梗死（STEMI）患者中，内皮祖细胞（EPCs）动员的主要刺激因素尚未完全阐明。我们旨在通过心脏磁共振（CMR）评估缺血心肌（危险区（AAR））或坏死心肌（梗死面积（IS））的程度是否与循环 EPCs 水平相关。
方法
在成功进行经皮冠状动脉介入治疗（pPCI）后 24 小时，对 15 例 STEMI 患者进行外周血 EPC 测量。在 pPCI 后 2 至 4 天，所有患者均接受 CMR 评估心肌 AAR、IS、心肌挽救（MS）和晚期钆增强 CMR 中的微血管阻塞（LG-MVO）。
结果
CD34+/KDR+、CD34+/KDR+/CD45dim、CD34+/KDR+/CD45-，EPCs 与 AAR 程度相关（rho=0.51，p=0.05；rho=0.55，p=0.03；rho=0.72，p=0.002），而与 IS、MS 或 LG-MVO 无相关性。
结论
我们的数据表明，EPCs 与心肌 AAR 程度密切相关，提示 STEMI 中祖细胞动员是对心肌缺血而非心肌坏死的反应。
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