Increased expression of cell adhesion molecule receptors on monocyte subsets in ischaemic heart failure

Area of Science:

• Cardiovascular Medicine
• Immunology
• Cell Biology

Background:

• Increased soluble cell adhesion molecules (CAMs) are noted in heart failure (HF), but mechanisms of monocyte adhesion are unclear.
• Monocyte subsets play distinct roles in inflammation and vascular interactions.
• Understanding monocyte receptor expression is crucial for elucidating HF pathogenesis.

Purpose of the Study:

• To evaluate integrin expression (CAM receptors) on monocyte subsets in patients with acute heart failure (AHF), stable heart failure (SHF), and stable coronary artery disease (CAD).
• To determine the prognostic significance of these receptor expressions in HF.
• To investigate the specific monocyte subsets involved in altered adhesion molecule interactions during HF.

Main Methods:

• Flow cytometry was used to assess integrin expression (ICAM-1R, VCAM-1R) on defined monocyte subsets (Mon1, Mon2, Mon3).
• Patient groups included AHF (n=51), SHF (n=42), and stable CAD (n=44).
• Multivariate Cox regression analysis identified predictors of adverse clinical outcomes (death or rehospitalization).

Main Results:

• AHF patients showed significantly higher ICAM-1R expression on Mon2 compared to SHF patients.
• AHF patients exhibited significantly higher VCAM-1R expression on Mon2 compared to SHF patients.
• VCAM-1R expression on Mon2 was a significant predictor of adverse outcomes in AHF (HR 1.07, p=0.029).

Conclusions:

• Heart failure is associated with increased expression of ICAM-1 and VCAM-1 receptors on monocytes, predominantly on the intermediate (Mon2) subset.
• This enhanced receptor expression on Mon2 may contribute to monocyte adhesion and vascular inflammation in HF.
• VCAM-1R expression on Mon2 offers potential prognostic value for identifying patients with AHF at higher risk for adverse events.