City Hospital, University of Birmingham Centre for Cardiovascular Sciences, Birmingham B18 7QH, UK.
Eur J Clin Invest. 2013 Feb;43(2):121-30. doi: 10.1111/eci.12023. Epub 2012 Dec 14.
Monocytes play important roles in inflammation, angiogenesis and tissue repair and may contribute to the pathophysiology of heart failure (HF).
We examined differences in monocyte subset numbers and expression of cell surface markers of activation (CD14) and chemotaxis (CCR2) in patients with acute HF (AHF), stable HF (SHF), and controls and evaluated their impact on clinical outcomes.
Three monocyte subsets [CD14++CD16-CCR2+ (Mon1), CD14++CD16+CCR2+ (Mon2) and CD14+CD16++CCR2- (Mon3)] were analysed by flow cytometry in 51 patients with AHF, 42 patients with SHF, 44 patients with stable coronary artery disease and without HF (CAD) and 40 healthy controls (HC). The prognostic impact of monocyte subsets was examined in AHF.
Patients with AHF had significantly higher Mon1 counts compared to the three control groups (P < 0·001 for all). Similarly, Mon2 levels were increased in AHF compared to SHF (P = 0·004) and CAD (P < 0·001) and increased in SHF vs. CAD (P = 0·009). There were no differences in Mon3 counts between the groups. Twenty patients (39·2%) with AHF reached the primary end-point of death or re-hospitalisation, and after adjustment for confounders, Mon2 count remained negatively associated with a combined end-point of death and re-hospitalisation [hazard ratio (per 10 cells/μL): 0·79; confidence interval: 0·66-0·94; P = 0·009].
Mon2 counts are increased in patients with both acute and stable HF, with enhanced expression of surface markers of activation (CD14) and chemotaxis (CCR2). This subset was also associated with an adverse prognosis in patients with AHF.
单核细胞在炎症、血管生成和组织修复中发挥重要作用，可能有助于心力衰竭（HF）的病理生理学。
我们检查了急性心力衰竭（AHF）、稳定心力衰竭（SHF）和对照组患者单核细胞亚群数量和细胞表面激活标志物（CD14）和趋化因子（CCR2）表达的差异，并评估了它们对临床结局的影响。
通过流式细胞术分析了 51 例 AHF 患者、42 例 SHF 患者、44 例稳定型冠心病且无心力衰竭（CAD）患者和 40 例健康对照者（HC）中的三种单核细胞亚群[CD14++CD16-CCR2+（Mon1）、CD14++CD16+CCR2+（Mon2）和 CD14+CD16++CCR2-（Mon3）]。在 AHF 中检查了单核细胞亚群的预后影响。
与所有三组对照相比，AHF 患者的 Mon1 计数显著升高（所有 P<0·001）。同样，与 SHF（P=0·004）和 CAD（P<0·001）相比，AHF 中的 Mon2 水平升高，与 SHF 相比，CAD 中的 Mon2 水平升高（P=0·009）。各组之间 Mon3 计数无差异。20 例（39·2%）AHF 患者达到死亡或再住院的主要终点，在调整混杂因素后，Mon2 计数与死亡和再住院的联合终点仍呈负相关[风险比（每 10 个细胞/μL）：0·79；置信区间：0·66-0·94；P=0·009]。
急性和稳定型 HF 患者的 Mon2 计数增加，表面激活标志物（CD14）和趋化因子（CCR2）的表达增强。该亚群与 AHF 患者的不良预后相关。
