title: CD14++CD16+ monocytes in patients with acute ischaemic heart failure.
abstract: BACKGROUND
  Monocytes play important roles in inflammation, angiogenesis and tissue repair and may contribute to the pathophysiology of heart failure (HF).
  
  
  OBJECTIVE
  We examined differences in monocyte subset numbers and expression of cell surface markers of activation (CD14) and chemotaxis (CCR2) in patients with acute HF (AHF), stable HF (SHF), and controls and evaluated their impact on clinical outcomes.
  
  
  METHODS
  Three monocyte subsets [CD14++CD16-CCR2+ (Mon1), CD14++CD16+CCR2+ (Mon2) and CD14+CD16++CCR2- (Mon3)] were analysed by flow cytometry in 51 patients with AHF, 42 patients with SHF, 44 patients with stable coronary artery disease and without HF (CAD) and 40 healthy controls (HC). The prognostic impact of monocyte subsets was examined in AHF.
  
  
  RESULTS
  Patients with AHF had significantly higher Mon1 counts compared to the three control groups (P < 0·001 for all). Similarly, Mon2 levels were increased in AHF compared to SHF (P = 0·004) and CAD (P < 0·001) and increased in SHF vs. CAD (P = 0·009). There were no differences in Mon3 counts between the groups. Twenty patients (39·2%) with AHF reached the primary end-point of death or re-hospitalisation, and after adjustment for confounders, Mon2 count remained negatively associated with a combined end-point of death and re-hospitalisation [hazard ratio (per 10 cells/μL): 0·79; confidence interval: 0·66-0·94; P = 0·009].
  
  
  CONCLUSIONS
  Mon2 counts are increased in patients with both acute and stable HF, with enhanced expression of surface markers of activation (CD14) and chemotaxis (CCR2). This subset was also associated with an adverse prognosis in patients with AHF.
authors.affiliation: City Hospital, University of Birmingham Centre for Cardiovascular Sciences, Birmingham B18 7QH, UK.
authors.forename: Benjamin J
authors.initials: BJ
authors.lastname: Wrigley
authors.forename: Eduard
authors.initials: E
authors.lastname: Shantsila
authors.forename: Luke D
authors.initials: LD
authors.lastname: Tapp
authors.forename: Gregory Y H
authors.initials: GY
authors.lastname: Lip
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D016022:Case-Control Studies; D005260:Female; D005434:Flow Cytometry; D058851:GPI-Linked Proteins / Q000378:metabolism; D006333:Heart Failure / Q000276:immunology*; D006801:Humans; D007958:Leukocyte Count; D018950:Lipopolysaccharide Receptors / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000276:immunology*; D017202:Myocardial Ischemia / Q000276:immunology*; D054390:Receptors, CCR2 / Q000378:metabolism*; D017452:Receptors, IgG / Q000378:metabolism*; D012044:Regression Analysis
chemical_list: D015415:Biomarkers; C515334:CCR2 protein, human; C428200:FCGR3B protein, human; D058851:GPI-Linked Proteins; D018950:Lipopolysaccharide Receptors; D054390:Receptors, CCR2; D017452:Receptors, IgG