Montoro-García Silvia, Shantsila Eduard, Wrigley Benjamin J, Tapp Luke D, Abellán Alemán José, Lip Gregory Y H
University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, United Kingdom; Departamento de Riesgo Cardiovascular, Facultad de Ciencias de la Salud, Universidad Católica San Antonio de Murcia (UCAM), Guadalupe, Murcia, Spain.
University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, United Kingdom.
Rev Esp Cardiol (Engl Ed). 2015 Nov;68(11):951-8. doi: 10.1016/j.rec.2014.11.016. Epub 2015 Mar 26.
Microparticles are markers for cell activation and apoptosis and could provide valuable information that is not available from clinical data. This study assesses the clinical and biological relationship of small-sized microparticles in different forms of ischemic systolic heart failure and their relation to markers of inflammation and repair.
We compared 49 patients with acute heart failure, 39 with stable heart failure and 25 patients with stable coronary artery disease. Small-size microparticles counts were determined by high-resolution flow cytometry. Moreover, 3 different monocyte subpopulations and their expression of inflammatory and adhesive scavenger receptors were analyzed using a conventional flow cytometer.
Endothelial CD144+ microparticle counts were decreased in heart failure groups (P=.008). Annexin V-binding microparticle counts were found increased in heart failure (P=.024) and in patients with lower functional class (P=.013). Platelet CD42b+ microparticle counts positively correlated with left ventricular ejection fraction (P=.006), and annexin V-binding microparticle counts with interleukin-6 levels in stable heart failure (P=.034). Annexin V-binding microparticle counts in the acute status strongly correlated with toll-like receptor-4 expression on all monocyte subsets (all P<.01). Three months after admission with acute heart failure, annexin V-binding microparticle counts were positively correlated with receptors for interleukin-6, CD163 and CD204 (all P<.05).
Annexin V-binding microparticle counts constitute valuable hallmarks of acute decompensated state in systolic heart failure. The observed relationship between small-size annexin V-binding microparticles and scavenger receptors supports their involvement in the progression of the acute response to injury, and thus their contribution to the pathogenesis of acute decompensated heart failure.
微粒是细胞活化和凋亡的标志物，能够提供临床数据中所没有的重要信息。本研究评估了不同形式的缺血性收缩性心力衰竭中，小型微粒的临床和生物学关系，以及它们与炎症和修复标志物的关系。
我们比较了49例急性心力衰竭患者、39例稳定心力衰竭患者和25例稳定冠状动脉疾病患者。通过高分辨率流式细胞术测定小型微粒计数。此外，使用传统流式细胞仪分析3种不同的单核细胞亚群及其炎症和黏附清除受体的表达。
心力衰竭组中内皮细胞CD144+微粒计数降低（P = 0.008）。在心力衰竭患者（P = 0.024）和心功能分级较低的患者中（P = 0.013），发现膜联蛋白V结合微粒计数增加。血小板CD42b+微粒计数与左心室射血分数呈正相关（P = 0.006），在稳定心力衰竭中，膜联蛋白V结合微粒计数与白细胞介素-6水平呈正相关（P = 0.034）。急性状态下膜联蛋白V结合微粒计数与所有单核细胞亚群上的Toll样受体4表达密切相关（所有P < 0.01）。急性心力衰竭入院3个月后，膜联蛋白V结合微粒计数与白细胞介素-6受体、CD163和CD204呈正相关（所有P < 0.05）。
膜联蛋白V结合微粒计数是收缩性心力衰竭急性失代偿状态的重要标志。观察到的小型膜联蛋白V结合微粒与清除受体之间的关系，支持它们参与损伤急性反应的进展，从而对急性失代偿性心力衰竭的发病机制有一定作用。
