Post-reperfusion enhancement of CD14(+)CD16(-) monocytes and microvascular obstruction in ST-segment elevation acute myocardial infarction.
BACKGROUND
The presence of microvascular obstruction (MVO) after primary ST-segment elevation acute myocardial infarction (STEMI) is associated with a poor outcome. The aim of the paper was to examine the relationship between distinct monocyte subsets and gadolinium-enhanced cardiovascular magnetic resonance (CMR) characteristics of MVO after STEMI.


RESULTS
Seventy-one patients with primary STEMI successfully treated with stenting were enrolled in the study. Two monocyte subsets (CD14(+)CD16(-) and CD14(+)CD16(+)) were measured on flow cytometry on admission and 2, 3, 4, 5, 8 days after the onset of STEMI. CMR was performed 7 days after revascularization to determine MVO on late gadolinium-enhanced imaging. The peak levels of CD14(+)CD16(-) monocytes, but not those of CD14(+)CD16(+) monocytes, were significantly higher in patients with MVO than in those without MVO. A multivariate logistic regression model showed that the post-perfusion peak levels of CD14(+)CD16(-) monocytes remained an independent factor for the presence of MVO (odds ratio=1.53; 95% confidence interval: 1.01-2.32; P=0.04). The absence of MVO was significantly associated with improvement in left ventricular ejection fraction.


CONCLUSIONS
Post-reperfusion enhancement of CD14(+)CD16(-) monocytes was associated with MVO in patients with STEMI. The pathophysiologic and therapeutic implications of this association require further study.
Tsujioka
Hiroto
H
Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
Imanishi
Toshio
T
Ikejima
Hideyuki
H
Tanimoto
Takashi
T
Kuroi
Akio
A
Kashiwagi
Manabu
M
Okochi
Keishi
K
Ishibashi
Kohei
K
Komukai
Kenichi
K
Ino
Yasushi
Y
Kitabata
Hironori
H
Akasaka
Takashi
T
D000368:Aged; D003328:Coronary Thrombosis / Q000175:diagnosis*; D005260:Female; D005434:Flow Cytometry; D005682:Gadolinium; D006801:Humans; D018950:Lipopolysaccharide Receptors; D018810:Magnetic Resonance Angiography; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D009000:Monocytes / Q000473:pathology*; D009203:Myocardial Infarction / Q000150:complications / Q000473:pathology*; D017452:Receptors, IgG; D015424:Reperfusion
D018950:Lipopolysaccharide Receptors; D017452:Receptors, IgG; D005682:Gadolinium