Impact of Heterogeneity of Human Peripheral Blood Monocyte Subsets on Myocardial Salvage in Patients With Primary Acute Myocardial Infarction
Impact of Heterogeneity of Human Peripheral Blood Monocyte Subsets on Myocardial Salvage in Patients With Primary Acute Myocardial Infarction
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DOI：
10.1016/j.jacc.2009.04.021
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发表时间：
2009-07-07
影响因子：
24
通讯作者：
Akasaka, Takashi
中科院分区：
文献类型：
--
作者：
Tsujioka, Hiroto;Imanishi, Toshio;Akasaka, Takashi
目的：我们研究不同的单核细胞亚群是否以特定的方式对急性心肌梗死（AMI）患者的心肌挽救做出贡献。最近的研究表明，人外周血中的单核细胞是异质的。方法对36例原发性AMI患者进行分析。AMI发病后1、2、3、4、5、8、12天采集外周血。流式细胞术检测两个单核细胞亚群（CD14（+）、CD16（-）和CD14（+）、CD16(+)）。心肌梗死后7天的心肌恢复程度通过心血管磁共振成像评价心肌危象（t2加权高信号病变）和心肌坏死（延迟钆增强）的差异。AMI后6个月也行心血管磁共振成像。结果AMI患者循环CD14(+)CD16（-）和CD14(+)CD16（+）单核细胞升高，分别在发病后第3天和第5天达到峰值。重要的是，CD14(+)CD16（-）单核细胞的峰值水平与心肌挽救程度呈显著负相关，而CD14(+)CD16（+）单核细胞的峰值水平与心肌挽救程度呈显著负相关。我们还发现，CD14(+)CD16（-）单核细胞的峰值水平与梗死后6个月左室射血分数的恢复呈负相关，而CD14(+)CD16（+）单核细胞的峰值水平与梗死后6个月左室射血分数的恢复呈负相关。结论心肌梗死后CD14（+）和CD16（-）单核细胞的峰值水平影响心肌的挽救程度和左心室功能的恢复，提示单核细胞异质性的调控可能成为挽救缺血性损伤的新靶点。[J]中华医学会心脏科杂志2009；54:130-8
Objectives We examined whether distinct monocyte subsets contribute in specific ways to myocardial salvage in patients with acute myocardial infarction (AMI).Background Recent studies have shown that monocytes in human peripheral blood are heterogeneous.Methods We studied 36 patients with primary AMI. Peripheral blood sampling was performed 1, 2, 3, 4, 5, 8, and 12 days after AMI onset. Two monocyte subsets (CD14(+)CD16(-) and CD14(+)CD16(+)) were measured by flow cytometry. The extent of myocardial salvage 7 days after AMI was evaluated by cardiovascular magnetic resonance imaging as the difference between myocardium at risk (T2-weighted hyperintense lesion) and myocardial necrosis (delayed gadolinium enhancement). Cardiovascular magnetic resonance imaging was also performed 6 months after AMI.Results Circulating CD14(+)CD16(-) and CD14(+)CD16(+) monocytes increased in AMI patients, peaking on days 3 and 5 after onset, respectively. Importantly, the peak levels of CD14(+)CD16(-) monocytes, but not those of CD14(+)CD16(+) monocytes, were significantly negatively associated with the extent of myocardial salvage. We also found that the peak levels of CD14(+)CD16(-) monocytes, but not those of CD14(+)CD16(+) monocytes, were negatively correlated with recovery of left ventricular ejection fraction 6 months after infarction.Conclusions The peak levels of CD14(+)CD16(-) monocytes affect both the extent of myocardial salvage and the recovery of left ventricular function after AMI, indicating that the manipulation of monocyte heterogeneity could be a novel therapeutic target for salvaging ischemic damage. (J Am Coll Cardiol 2009; 54:130-8) (C) 2009 by the American College of Cardiology Foundation