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CD14++CD16+ monocytes in patients with acute ischaemic heart failure
Benjamin J Wrigley1, Eduard Shantsila, Luke D Tapp
1City Hospital, University of Birmingham Centre for Cardiovascular Sciences, Birmingham B18 7QH, UK.
Insights
Monocyte subset Mon2 is elevated in acute and stable heart failure (HF) patients. Higher Mon2 counts in acute HF predict adverse clinical outcomes, indicating its role in HF pathophysiology.
Area of Science:
- Immunology
- Cardiology
- Pathophysiology
Background:
- Monocytes are crucial in inflammation, angiogenesis, and tissue repair.
- These functions suggest a potential role for monocytes in heart failure (HF) pathophysiology.
Purpose of the Study:
- To investigate differences in monocyte subset numbers and cell surface marker expression (CD14, CCR2) in patients with acute HF (AHF), stable HF (SHF), and controls.
- To evaluate the impact of these monocyte subsets on clinical outcomes in AHF patients.
Main Methods:
- Flow cytometry was used to analyze three monocyte subsets (Mon1, Mon2, Mon3) in patients with AHF, SHF, coronary artery disease (CAD), and healthy controls (HC).
- The prognostic significance of monocyte subsets was assessed in AHF patients.
Main Results:
- Patients with AHF exhibited significantly higher Mon1 counts than all control groups.
- Mon2 levels were elevated in AHF compared to SHF and CAD, and in SHF compared to CAD.
- Mon2 count was a negative predictor of death or re-hospitalization in AHF patients.
Conclusions:
- Monocyte subset Mon2 shows increased counts and enhanced expression of CD14 and CCR2 in both acute and stable HF patients.
- Elevated Mon2 subset counts are associated with an adverse prognosis in patients experiencing acute heart failure.
Background:
Monocytes play important roles in inflammation, angiogenesis and tissue repair and may contribute to the pathophysiology of heart failure (HF).
Objectives:
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.
Methods:
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.
Results:
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].
Conclusions:
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.
