title: Increased high mobility group box-1 protein levels are associated with impaired cardiopulmonary and echocardiographic findings after acute myocardial infarction.
abstract: BACKGROUND
  Several markers of systemic inflammation seem to play an active role in the pathophysiology of acute coronary syndrome and its evolution. High mobility group box-1 (HMGB-1), a ubiquitous nuclear protein constitutively expressed in quiescent cells, was recently recognized as a newer critical mediator of inflammatory diseases. The present study aimed to evaluate the possible association between HMGB-1 levels and structural and functional indices of cardiovascular performance such as cardiopulmonary and Doppler-echocardiography indices in patients after acute myocardial infarction (MI).
  
  
  RESULTS
  Fifty-four consecutive patients (mean age 58.3 years, 83% males) recovering from acute MI were included in the study protocol. All patients underwent Doppler-echocardiography, cardiopulmonary exercise, and HMGB-1 assay. HMGB-1 levels in acute MI patients were significantly higher compared with age- and body mass index-matched controls (14.8 +/- 6.8 vs. 2.3 +/- 1.0 ng/mL, P < .0001, respectively). Postinfarction patients showed oxygen consumption at peak exercise (VO(2 peak)) = 14.4 +/- 4.2 mL x kg x min and a slope of increase in ventilation over carbon dioxide output (VE/VCO(2 slope)) = 32.1 +/- 6.2, whereas Doppler-echocardiography values were: left ventricular end-diastolic volume (LVEDV) = 53.4 +/- 8.2 mL/m(2); left ventricular ejection fraction (LVEF) = 41.7 +/- 7.0%. Multiple linear regression analysis (stepwise method) showed that VO(2 peak) (beta = -0.276, P = .012), VE/VCO(2 slope) (beta = 0.244, P = .005), LVEDV (beta = 0.267, P = .018), peak creatine kinase-MB (beta = 0.339, P = .004), peak Troponin I (beta = 0.244, P = .002), and LVEF (beta = -0.312, P = .021) were significantly associated with HMGB-1 levels.
  
  
  CONCLUSIONS
  The present study demonstrated that in postinfarction patients, HMGB-1 levels were significantly higher compared with controls, and significantly correlated with cardiopulmonary and Doppler-echocardiography parameters.
authors.affiliation: Division of Cardiology, University of Naples Federico II, Naples, Italy. pcirillo@unina.it
authors.forename: Plinio
authors.initials: P
authors.lastname: Cirillo
authors.forename: Francesco
authors.initials: F
authors.lastname: Giallauria
authors.forename: Mario
authors.initials: M
authors.lastname: Pacileo
authors.forename: Gianluca
authors.initials: G
authors.lastname: Petrillo
authors.forename: Mariantonietta
authors.initials: M
authors.lastname: D'Agostino
authors.forename: Carlo
authors.initials: C
authors.lastname: Vigorito
authors.forename: Massimo
authors.initials: M
authors.lastname: Chiariello
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002478:Cells, Cultured; D015150:Echocardiography, Doppler / Q000379:methods*; D005080:Exercise Test / Q000379:methods*; D005260:Female; D024243:HMGB1 Protein / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000000981:diagnostic imaging* / Q000503:physiopathology
chemical_list: D015415:Biomarkers; D024243:HMGB1 Protein