Department of Cardiology, Cardiovascular Center, Korea University Anam Hospital, Seoul, Korea.
Circ J. 2012;76(5):1213-21. doi: 10.1253/circj.cj-11-1485. Epub 2012 Feb 21.
The correlations between circulating angiogenic cell mobilizations and improvement of microvascular integrity were investigated in patients (n=110) with acute myocardial infarction (AMI) during an 8-month follow up.
Coronary flow reserve (CFR) was measured at baseline and at 8 months by using an intracoronary Doppler wire. Serial changes in the absolute numbers of circulating angiogenic cells such as CD34+, CXCR4+, CD117+, CD133+ and C-met+ were measured at baseline, day 1, day 5 and at 8 months. The absolute numbers of circulating angiogenic cells at day 1 were significantly higher than those at baseline. A positive correlation was found between the numbers of circulating angiogenic cells of CD34+, CXCR4+, CD117+ and CD133+ cells at day 1 and the CFR changes from baseline. The cut-off value of CFR changes at 8 months by a receiver operating characteristic curve between a circulating CD34+ cell at day 1 and changes of CFR at 8 months was 0. Late-loss showed the positive correlation with the absolute number of C-met+ cells and the negative correlation with the absolute number of CXCR4+ cells after AMI. The negative correlation was found between changes in high-sensitive C-reactive protein and soluble intercellular adhesion molecule-1 and changes in CFR at 8 months.
The recovery of microvascular integrity after acute ischemic injury was expedited by the increases in circulating angiogenic cell mobilization together with the greater decreases in inflammatory cytokines. The improvement in CFR could be predicted by the measurement of circulating angiogenic cells after AMI.
本研究旨在探讨急性心肌梗死(AMI)患者循环血管生成细胞动员与微血管完整性改善的相关性,并对 110 例 AMI 患者进行了 8 个月的随访。
通过冠状动脉多普勒导丝在基线和 8 个月时测量冠状动脉血流储备(CFR)。在基线、第 1 天、第 5 天和第 8 个月测量循环血管生成细胞(如 CD34+、CXCR4+、CD117+、CD133+和 C-met+)的绝对数量的变化。第 1 天的循环血管生成细胞的绝对数量明显高于基线水平。第 1 天 CD34+、CXCR4+、CD117+和 CD133+细胞的循环血管生成细胞数量与从基线开始的 CFR 变化之间存在正相关。通过第 1 天的循环 CD34+细胞和 8 个月时的 CFR 变化的受试者工作特征曲线,CFR 变化的 8 个月截断值为 0。晚期丢失与 AMI 后 C-met+细胞的绝对数量呈正相关,与 CXCR4+细胞的绝对数量呈负相关。高敏 C 反应蛋白和可溶性细胞间黏附分子-1 的变化与 8 个月时的 CFR 变化呈负相关。
急性缺血性损伤后,通过增加循环血管生成细胞的动员,同时减少炎症细胞因子,加速了微血管完整性的恢复。通过 AMI 后循环血管生成细胞的测量,可以预测 CFR 的改善。