Medizinische Klinik III, Kardiologie und Kreislauferkrankungen, Eberhard-Karls-Universität Tübingen, Germany.
Eur J Radiol. 2012 Apr;81(4):e486-90. doi: 10.1016/j.ejrad.2011.06.019. Epub 2011 Jul 2.
Platelet-derived stromal-cell-derived factor-1 (SDF-1) plays an important role in trafficking hematopoetic progenitor cells for tissue regeneration and neovascularisation. The aim was to evaluate platelet-SDF-1 and CD34(+) progenitor cells in patients with acute myocardial infarction (AMI) compared with hemodynamic function and infarct size using late gadolinium enhancement (LGE) cardiac magnetic resonance (CMR) imaging.
We consecutively evaluated 40 patients with AMI, who received coronary angiography for primary coronary intervention. Blood was sampled for flow cytometry to determine mean fluorescence intensity (MFI) of platelet-SDF-1 and for isolation of CD34(+) progenitor cells. 48h and three months after coronary stenting, all patients underwent 1.5T CMR for volumetric assessment and LGE.
Patients with enhanced platelet-SDF-1 expression (median≥68.5MFI) showed a significant amelioration of left ventricular ejection fraction (LVEF) (baseline vs. follow-up mean±SD: 45±6% vs. 56±6%; P=0.018) and of stroke volume (73.1±19.1mL vs. 89.9±21.3mL; P=0.032) at three-month follow-up in contrast to patients with a decreased platelet-SDF-1 expression level (LVEF: 53±8% vs. 56±10%; P=0.267; stroke volume: 85.6±23.1mL vs. 87.4±23.2mL; P=0.803). Inversely, LGE infarct size showed significantly reduced in patients with enhanced platelet-SDF-1 expression at three months (18.9±12mL vs. 6.3±5.1mL; P=0.002) compared to patients with decreased platelet-SDF-1 (12.7±12.7mL vs. 7.6±8.4mL; P=0.156). Time-dependent autocorrelation coefficients shifted for both SV (lag 1: r=-0.368; P=0.001) and the number of CD34(+) cells (lag 1: r=0.633; P=0.001) to a positive autocorrelation (SV; lag 2: r=0.295; P=0.001; CD34(+) cells; lag 2: r=0.287; P=0.001). Patients with increased number of CD34(+) cells (median≥420cells/hpf) showed a significant amelioration of stroke volume in three-month follow-up (83.9±5.3mL vs. 99.4±4.1mL; P=0.020) compared with patients with decreased number of CD34(+) cells (69.3±4.1mL vs. 76.1±3.2mL; P=0.282).
Platelet-SDF-1 and number of CD34(+) progenitor cells are associated with CMR hemodynamic function in patients with AMI.
血小板衍生的基质细胞衍生因子-1（SDF-1）在组织再生和新生血管化中的造血祖细胞的运输中起着重要作用。本研究旨在通过使用钆延迟增强（LGE）心脏磁共振（CMR）成像，评估急性心肌梗死（AMI）患者的血小板-SDF-1和 CD34（+）祖细胞与血流动力学功能和梗死面积的关系。
我们连续评估了 40 名接受经皮冠状动脉介入治疗的 AMI 患者。采集血液用于流式细胞术以确定血小板-SDF-1 的平均荧光强度（MFI）和 CD34（+）祖细胞的分离。在冠状动脉支架置入后 48 小时和 3 个月，所有患者均进行 1.5T CMR 进行容积评估和 LGE。
与血小板-SDF-1 表达水平降低的患者相比，表达增强的血小板-SDF-1（中位数≥68.5MFI）的患者在 3 个月随访时左心室射血分数（LVEF）（基线与随访均值±SD：45±6% vs. 56±6%；P=0.018）和每搏量（73.1±19.1mL vs. 89.9±21.3mL；P=0.032）显著改善。相反，血小板-SDF-1 表达增强的患者在 3 个月时 LGE 梗死面积显著减小（18.9±12mL vs. 6.3±5.1mL；P=0.002），而血小板-SDF-1 表达降低的患者（12.7±12.7mL vs. 7.6±8.4mL；P=0.156）。SV（滞后 1：r=-0.368；P=0.001）和 CD34（+）细胞数量（滞后 1：r=0.633；P=0.001）的时间依赖性自相关系数均转为正自相关（SV；滞后 2：r=0.295；P=0.001；CD34（+）细胞；滞后 2：r=0.287；P=0.001）。CD34（+）细胞数量增加（中位数≥420 个/高倍视野）的患者在 3 个月随访时的每搏量明显改善（83.9±5.3mL vs. 99.4±4.1mL；P=0.020），而 CD34（+）细胞数量减少的患者（69.3±4.1mL vs. 76.1±3.2mL；P=0.282）。
血小板-SDF-1 和 CD34（+）祖细胞数量与 AMI 患者的 CMR 血流动力学功能相关。
