Jiménez-Navarro Manuel F, González Francisco Jesús, Caballero-Borrego Juan, Marchal Juan Antonio, Rodríguez-Losada Noela, Carrillo Esmeralda, García-Pinilla José Manuel, Hernández-García José M, Pérez-González Rita, Ramírez Gemma, Aránega Antonia, de Teresa Galván Eduardo
Área del Corazón, Hospital Clínico Universitario Virgen de la Victoria, Málaga, España.
Rev Esp Cardiol. 2011 Dec;64(12):1123-9. doi: 10.1016/j.recesp.2011.07.003. Epub 2011 Oct 2.
Multivessel coronary disease is still a postinfarction prognostic marker despite new forms of reperfusion, such as primary angioplasty. The aim of this study was to determine the time sequence of various sets of endothelial progenitor cells and angiogenic cytokines (vascular endothelial growth factor, hepatocyte growth factor) according to the degree of extension of the postinfarction coronary disease.
We studied the release kinetics in 32 patients admitted for a first myocardial infarction with ST elevation, grouped according to whether they had single or multivessel disease, and 26 controls.
The patients had a higher number of endothelial progenitor cells and angiogenic cytokines than the controls at all 3 measurements (admission, day 3, and day 7) of the following subsets: CD34, CD34+CD133+, CD34+KDR+, and CD34+CD133+KDR+CD45+(weak); this latter was higher on day 7. The levels of these cell subsets were all higher in the patients with single-vessel disease and at all 3 measurements. The vascular endothelial growth factor levels were raised during the first week and the hepatocyte growth factor showed an early peak on admission for infarction. No significant differences were seen in the cytokines according to coronary disease extension.
Although the release kinetics of different subsets of endothelial progenitor cells in patients with a first acute myocardial infarction with ST elevation was similar in those with single vessel disease to those with multivessel disease, the number of circulating endothelial progenitor cells was greater in the patients with single vessel disease. The vascular endothelial growth factor levels were raised during the first postinfarction week and the hepatocyte growth factor were higher on admission.
尽管有新的再灌注形式，如直接血管成形术，但多支冠状动脉疾病仍是心肌梗死后的预后标志物。本研究的目的是根据心肌梗死后冠状动脉疾病的扩展程度，确定不同组内皮祖细胞和血管生成细胞因子（血管内皮生长因子、肝细胞生长因子）的时间序列。
我们研究了32例因首次ST段抬高型心肌梗死入院的患者的释放动力学，根据他们是否患有单支或多支血管疾病进行分组，并与26名对照组进行比较。
在以下亚组的所有3次测量（入院时、第3天和第7天）中，患者的内皮祖细胞和血管生成细胞因子数量均高于对照组：CD34、CD34+CD133+、CD34+KDR+和CD34+CD133+KDR+CD45+（弱阳性）；后者在第7天更高。这些细胞亚组的水平在单支血管疾病患者中以及所有3次测量时均更高。血管内皮生长因子水平在第一周升高，肝细胞生长因子在梗死入院时出现早期峰值。根据冠状动脉疾病扩展情况，细胞因子未见显著差异。
尽管首次急性ST段抬高型心肌梗死患者中，单支血管疾病患者与多支血管疾病患者不同亚组内皮祖细胞的释放动力学相似，但单支血管疾病患者循环内皮祖细胞数量更多。血管内皮生长因子水平在心肌梗死后第一周升高，肝细胞生长因子在入院时更高。
