title: Initial results of inflammatory response, matrix remodeling, and reactive oxygen species following PCI in acute ischemic myocardial injury in man.
abstract: BACKGROUND
  Neutrophils and reactive oxygen species (ROS) are suggested to be involved in irreversible myocardial reperfusion injury and stunning. We investigated the relations between circulating biochemical markers and myocardium at risk (MaR), myocardial infarct (MI) size, salvage, and recovery of function in man.
  
  
  RESULTS
  In patients undergoing PCI serial blood samples were acquired for markers of inflammatory response (myeloperoxidase [MPO], neutrophil-gelatinase-associated lipocalin [NGAL], interleukins 6 and 8 [IL-6/8], tumor necrosis factor-a [TNF-a], high-sensitive C-reactive protein [hsCRP]), matrix remodeling (matrixmetalloproteinase-9 [MMP-9]) and ROS (malondialdehyde [MDA], isoprostane [IsoP]). Samples were obtained before PCI and 1.5, 3, and 24 hours after reperfusion. Myocardial perfusion SPECT (MPS) was used to assess MaR. Late gadolinum-enhanced cardiac magnetic resonance imaging was performed for regional function in the acute setting, at 1 week and 6 months, and at 1 week also for MI size. Sixteen patients (15 men; 42-78 years) were enrolled, 12 of whom underwent MPS. Peak and cumulative NGAL and cumulative MMP-9 showed inverse correlations to MaR. No correlation was found for MI size. Peak MPO correlated inversely to salvage and to recovery of regional function in the infarcted segments at 1 week and 6 months.
  
  
  CONCLUSIONS
  This is the first study in man to show inverse relations between circulating NGAL and MMP-9 and MaR. The current results do not support that ROS has a role in stunning in man. MI size showed no significant correlation to any parameter, challenging inflammatory treatment in reperfusion.
authors: Department of Clinical Physiology, Lund, Sweden. hakan.arheden@med.lu.se
authors: Erik
authors: E
authors: Hedström
authors: Karin
authors: K
authors: Aström-Olsson
authors: Ann-Kristin
authors: AK
authors: Ohlin
authors: Hans
authors: H
authors: Ohlin
authors: Håkan
authors: H
authors: Arheden
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D015415:Biomarkers; D002097:C-Reactive Protein; D005260:Female; D006801:Humans; D007249:Inflammation / Q000209:etiology / Q000473:pathology; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000276:immunology*; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D017202:Myocardial Ischemia / Q000209:etiology* / Q000473:pathology; D015425:Myocardial Reperfusion / Q000009:adverse effects; D009504:Neutrophils; D017382:Reactive Oxygen Species; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D015415:Biomarkers; D017382:Reactive Oxygen Species; D002097:C-Reactive Protein; D020780:Matrix Metalloproteinase 9