Apelinergic System in the Left Ventricle Adverse Remodeling After Myocardial Infarction: A Preliminary Study

Despite a growing evidence from the animal models of the cardioprotective function of the apelinergic system in the setting of myocardial infarction, little is known on the role of apelinergic system in the development of post- infarction adverse left ventricle remodeling in humans.

The study group consisted of 49 patients with first-time ST-segment elevation myocardial infarction of anterior wall treated invasively. Echocardiography was performed on index hospitalization and on one-year check-up, with categorizing the study population into group with adverse LV remodeling defined as an increase of LV end diastolic volume by >20% (n = 12) and the group without adverse remodeling (n = 29). ELA, AP-17, AP-13 and APJ receptor levels were measured on one-year follow-up.

Patients with adverse LV remodeling presented significantly higher plasma level of apelin-13 (85.63 [75.43-96.13] vs 65.43 [57.35-69.35], p = 0.001) and apelin-17 (69.36 [42.61-77.04] vs 30.04 [25.97-41.95], p = 0.004). In a univariable logistic regression analysis, higher LVEDV and LVEDV1, higher LVESV and LVESVi, lower LVEF, higher WMSI score, higher SYNTAX score, higher levels of hs-CRP during index hospitalization and higher levels of AP-13 and AP-17 on the one-year check-up were associated with adverse LV remodeling. In multivariable logistic regression analysis, only AP-17 level was independently associated with adverse LV remodeling (p = 0.050).

Apelinergic system may be involved in the development of post- infarction adverse left ventricle remodeling.