Universidade Federal de São Paulo, São Paulo, Brazil.
Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil.
Biosci Rep. 2021 Feb 26;41(2). doi: 10.1042/BSR20203413.
Despite early reperfusion, patients with ST segment elevation myocardial infarction (STEMI) may present large myocardial necrosis and significant impairment of ventricular function. The present study aimed to evaluate the role of subtypes of B lymphocytes and related cytokines in the infarcted mass and left ventricular ejection fraction obtained by cardiac magnetic resonance imaging performed after 30 days of STEMI. This prospective study included 120 subjects with STEMI submitted to pharmacoinvasive strategy. Blood samples were collected in subjects in the first (D1) and 30th (D30) days post STEMI. The amount of CD11b+ B1 lymphocytes (cells/ml) at D1 were related to the infarcted mass (rho = 0.43; P=0.033), measured by cardiac MRI at D30. These B1 cells were associated with CD4+ T lymphocytes at D1 and D30, while B2 classic lymphocytes at day 30 were related to left ventricular ejection fraction (LVEF). Higher titers of circulating IL-4 and IL-10 were observed at D30 versus D1 (P=0.013 and P<0.001, respectively). Titers of IL-6 at D1 were associated with infarcted mass (rho = 0.41, P<0.001) and inversely related to LVEF (rho = -0.38, P<0.001). After multiple linear regression analysis, high-sensitivity troponin T and IL-6 collected at day 1 were independent predictors of infarcted mass and, at day 30, only HDL-C. Regarding LVEF, high-sensitivity troponin T and high-sensitivity C-reactive protein were independent predictors at day 1, and B2 classic lymphocytes, at day 30. In subjects with STEMI, despite early reperfusion, the amount of infarcted mass and ventricular performance were related to inflammatory responses triggered by circulating B lymphocytes.
尽管早期再灌注，ST 段抬高型心肌梗死（STEMI）患者可能出现大面积心肌坏死和心室功能显著受损。本研究旨在评估 B 淋巴细胞亚型及其相关细胞因子在 STEMI 后 30 天心脏磁共振成像获得的梗死面积和左心室射血分数中的作用。这项前瞻性研究纳入了 120 例接受药物侵入性治疗策略的 STEMI 患者。在 STEMI 后第 1 天（D1）和第 30 天（D30）采集受试者的血液样本。D1 时 CD11b+B1 淋巴细胞（细胞/ml）的数量与心脏 MRI 测量的 D30 时梗死面积相关（rho=0.43；P=0.033）。这些 B1 细胞与 D1 和 D30 时的 CD4+T 淋巴细胞相关，而 D30 时的 B2 经典淋巴细胞与左心室射血分数（LVEF）相关。与 D1 相比，D30 时循环 IL-4 和 IL-10 的滴度更高（P=0.013 和 P<0.001）。D1 时的 IL-6 滴度与梗死面积相关（rho=0.41，P<0.001），与 LVEF 呈负相关（rho=-0.38，P<0.001）。多元线性回归分析后，D1 时的高敏肌钙蛋白 T 和 IL-6 是梗死面积的独立预测因子，而在 D30 时，只有高密度脂蛋白胆固醇是独立预测因子。对于 LVEF，D1 时的高敏肌钙蛋白 T 和高敏 C 反应蛋白是独立预测因子，而在 D30 时，B2 经典淋巴细胞是独立预测因子。在 STEMI 患者中，尽管早期再灌注，梗死面积和心室功能仍与循环 B 淋巴细胞引发的炎症反应有关。
