Relation between high levels of myeloperoxidase in the culprit artery and microvascular obstruction, infarct size and reverse remodeling in ST-elevation myocardial infarction

To better understand the role of myeloperoxidases (MPO) in microvascular obstruction (MO) phenomenon and infarct size (IS) using cardiac magnetic resonance (CMR) data in patients with acute myocardial infarction (AMI). 40 consecutive patients classified according to the median level of MPO in the cu...

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Vydáno v:	PLOS ONE Ročník 12; číslo 7; s. e0179929
Hlavní autoři:	Stamboul, Karim, Zeller, Marianne, Rochette, Luc, Cottin, Yves, Cochet, Alexandre, Leclercq, Thibault, Porot, Guillaume, Guenancia, Charles, Fichot, Marie, Maillot, Nicolas, Vergely, Catherine, Lorgis, Luc, Bugiardini, Raffaele
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	United States Public Library of Science (PLoS) 13.07.2017 Public Library of Science
Témata:	[SDV.IB]Life Sciences [q-bio]/Bioengineering [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system Acute Coronary Syndromes Acute Coronary Syndromes, No-Reflow, Long-Term, Leukocyte, Dimethylarginine, Definition, Mortality, Disease Aged Arteries Arteries - enzymology Arteries - pathology Biology and Life Sciences Calcium-binding protein Cardiac patients Cardiology Cardiology and cardiovascular system Cardiovascular disease Definition Dimethylarginine Disease Epidemiology Female Gadolinium Health aspects Heart Heart attack Heart attacks Heart diseases Human health and pathology Humans Hypertension Infarction Ischemia Laboratories Leukocyte Life Sciences Long-Term Magnetic resonance Magnetic resonance imaging Magnetic Resonance Imaging, Cine Magnetic Resonance Imaging, Cine - methods Male Medicine Medicine and Health Sciences Microcirculation Microvasculature Middle Aged Mortality Myocardial infarction Neutrophils Nitric oxide NMR No-Reflow Nuclear magnetic resonance Patients Peroxidase Peroxidase - metabolism Plasma Prognosis Q R Remodeling Research Article Resonance Science ST Elevation Myocardial Infarction ST Elevation Myocardial Infarction - blood ST Elevation Myocardial Infarction - enzymology ST Elevation Myocardial Infarction - pathology Stroke Volume Troponin Ventricle Ventricular Function, Left Ventricular Remodeling France Acute Coronary Syndromes Disease Leukocyte Mortality Definition Long-Term Dimethylarginine No-Reflow
ISSN:	1932-6203, 1932-6203
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Shrnutí:	To better understand the role of myeloperoxidases (MPO) in microvascular obstruction (MO) phenomenon and infarct size (IS) using cardiac magnetic resonance (CMR) data in patients with acute myocardial infarction (AMI). 40 consecutive patients classified according to the median level of MPO in the culprit artery. A CMR study was performed during the week following AMI and at 6 months, with late gadolinium enhancement sequences. Persistent MO was observed in the same proportion (50 vs. 65%, p = 0.728) between the low vs. high MPO group levels. However, the extent of the microvascular obstruction was significantly greater in the high-MPO group (6 (0-9) vs.16.5 (0-31), p = 0.027), together with a greater infarct size, and a trend towards a lower left ventricular ejection fraction (LVEF) (p = 0.054) at one week. CMR data at 6 months showed that reverse systolic remodeling was two fold more present in the low-MPO group (p = 0.058). Interestingly, the extent of MO (8.5 (6.5-31) vs. 4.1 (3-11.55), p = 0.042) and IS remained significantly greater (24.5 (9.75-35) vs. 7.5 (2.5-18.75), p = 0.022) in the high-MPO group. Moreover, MPO in the culprit artery appeared to correlate positively with MPO in non-culprit arteries and serum, and with troponin levels and peak CK. This patient-based study revealed in patients after AMI that high MPO levels in the culprit artery were associated with more severe microvascular obstruction and greater IS. These findings may provide new insights pathophysiology explanation for the adverse prognostic impact of MO.
Bibliografie:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 PMCID: PMC5509133 Competing Interests: The authors have declared that no competing interests exist.
ISSN:	1932-6203 1932-6203
DOI:	10.1371/journal.pone.0179929