Predicting left ventricular remodeling after a first myocardial infarction by plasma proteome analysis
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Published on: January 28, 2020
Florence Pinet1, Olivia Beseme, Caroline Cieniewski-Bernard
1INSERM U744, Lille, France. florence.pinet@pasteur-lille.fr
Insights
Left ventricular remodeling (LVR) affects 30% of patients post-acute myocardial infarction (AMI). Comparative proteomics identified elevated haptoglobin variants (Hpalpha1) in remodeling patients, suggesting potential biomarkers for LVR risk.
Area of Science:
- Cardiology
- Proteomics
- Biomarker Discovery
Background:
- Left ventricular remodeling (LVR) is a common complication after acute myocardial infarction (AMI), occurring in 30% of cases despite therapeutic advances.
- Identifying reliable biomarkers for LVR is crucial for predicting heart failure risk post-AMI.
Purpose of the Study:
- To systematically identify circulating protein biomarkers associated with LVR after anterior wall Q-wave AMI using comparative proteomics.
- To evaluate the potential of these biomarkers in predicting LVR development and progression.
Main Methods:
- A prospective study of 93 patients with anterior wall Q-wave AMI, with echocardiographic follow-up at hospitalization, 3 months, and 1 year.
- Plasma samples collected on day 5 were analyzed using Surface-Enhanced Laser Desorption/Ionization-Time Of Flight (SELDI-TOF) protein chip technology.
- Patients were categorized into no, low, or high LVR groups based on echocardiographic data.
Main Results:
- Comparative proteomics identified post-translational variants of the alpha1-chain of haptoglobin (Hpalpha1) at m/z 9493, 9565, and 9623 as being significantly elevated in patients with LVR.
- The peak at 9493 m/z demonstrated a Receiver Operating Characteristic (ROC) value of 0.71 in distinguishing between remodeling and non-remodeling patients.
- These findings suggest a correlation between specific Hpalpha1 variants and the presence and severity of LVR.
Conclusions:
- The SELDI-TOF proteomic approach successfully identified candidate circulating proteins, specifically Hpalpha1 variants, associated with LVR after AMI.
- These identified Hpalpha1 variants hold promise as potential biomarkers for identifying patients at high risk of developing LVR and subsequent heart failure.
- Further validation studies are required to confirm the clinical utility of these biomarkers in predicting heart failure post-AMI.
Abstract:
Recent improvements in therapeutic strategies did not prevent left ventricular remodeling (LVR), which remains a common event (30%) after acute myocardial infarction (AMI). We report the use of a systematic approach, based on comparative proteomics, to select circulating biomarkers that may be associated with LVR. We selected 93 patients enrolled in a prospective study. These patients with anterior wall Q-wave AMI underwent echocardiographic follow-up at hospitalization, 3 months and 1 year after AMI. They were divided into three groups (no, low, or high remodeling). Plasma samples of these patients (day 5 of hospitalization) were processed and stored at -80 degrees C within 2 h and analyzed using SELDI-TOF protein chip technology. This systematic approach allowed to select candidate proteins modulated by LVR: post-translational variants of alpha1-chain of haptoglobin (Hpalpha1) corresponding to m/z 9493, 9565, and 9623, which were more elevated in remodeling patients. The peak 9493 m/z was shown having a receiving-operating characteristic (ROC) value of 0.71 between non- and remodeling patients. SELDI-TOF approach may lead to the identification of circulating proteins associated with LVR. Whether these candidate proteins will help to identify patients who are at high risk of heart failure after AMI will have to be tested in future studies.
