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Published on: February 16, 2016
Biomarker profiles as descriptors of left ventricular remodeling after acute myocardial infarction
Phillip H Lam1, Phillip R Anderson, Bina Ahmed
1Cardiology Division, Department of Medicine, University of Vermont, Burlington, USA.
Insights
Cytokine expression 24-72 hours after ST elevation myocardial infarction (STEMI) shows a shift towards tolerance, favoring growth factors and limiting cell-mediated immunity, potentially linked to positive ventricular remodeling.
Area of Science:
- Cardiovascular Medicine
- Immunology
- Biomarker Research
Background:
- Biomarker expression is crucial for predicting cardiovascular events.
- ST elevation myocardial infarction (STEMI) involving the left anterior descending (LAD) artery is a critical condition.
- Understanding post-STEMI inflammatory responses is key to patient outcomes.
Purpose of the Study:
- To investigate the expression patterns of cytokines and growth factors in blood 24-72 hours after LAD STEMI.
- To correlate these expression patterns with cardiac remodeling and function post-STEMI.
Main Methods:
- Blood samples were collected from 16 patients with LAD STEMI and 20 healthy volunteers.
- Cytokine and growth factor expression was quantified using a Milliplex cytokine/chemokine array (42 analytes).
- Analyte functions were categorized into T-helper cell responses (Th1/Th2), chemokines, and growth factors.
Main Results:
- Positive ventricular remodeling occurred in most patients (15/16) without significant reduction in left ventricular function.
- A predominant Th2 response (humoral immunity) was observed over Th1 response (cell-mediated immunity), suggesting a shift towards tolerance.
- Elevated growth factors were noted, while chemokines associated with cell-mediated immunity were not significantly increased.
Conclusions:
- Post-LAD STEMI cytokine profiles indicate a link between growth factor expression, limited cell-mediated immunity, and positive ventricular remodeling.
- Further research is needed to determine if deviations from this pattern predict adverse remodeling and poorer outcomes.
Background:
Biomarker expression can predict subsequent cardiovascular events. The goal of this study was to determine the pattern of expression in blood of a broad array of cytokines and growth factors taken 24-72 h after an ST elevation myocardial infarction (STEMI) involving the left anterior descending (LAD) coronary artery.
Methods:
Blood was taken from 16 patients with LAD STEMI. Cytokine and growth factor expressions were quantified with the use of a Milliplex cytokine/chemokine array analysis that tested 42 analytes. Results from patients were compared with those in blood from 20 healthy volunteers.
Results:
Most (15/16) participants had positive remodeling without reduction in left ventricular function during follow-up. Analytes were grouped based on their function into those that activate class 1 T-helper cells (Th1 activates cell-mediated immunity), those that activated a Th2 response (activates humoral immunity and attenuates cell-mediated immunity), chemokines (attract leukocytes), and growth factors (promote a healing response). Elevation of cytokines involved in the Th2 response predominated over the Th1 response demonstrating a balance favoring tolerance and limiting activation of cell-mediated immunity. The concentration of selected chemokines favoring cell-mediated immunity was not elevated. The concentration of selected growth factors was increased.
Conclusion:
The cytokine expression, 24-72 h after an LAD STEMI, suggests that positive ventricular remodeling is associated with growth factor expression and limitation of cell-mediated immunity. Subsequent studies are warranted to determine whether deviation from this pattern identifies patients at an increased risk of adverse remodeling after myocardial infarction.
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