title: Characterization of pericardial and plasma ghrelin levels in patients with ischemic and non-ischemic heart disease.
abstract: Ghrelin is an endocrine regulatory peptide with multiple functions including cardioprotective effects. It is produced in various tissues among others in the myocardium. Pericardial fluid has been proven to be a biologically active compartment of the heart that communicates with the myocardial interstitium. Thus, pericardial level of certain agents may reflect their concentration in the myocardium well. In our study we measured acylated (active) and total (acylated and non-acylated) pericardial and plasma ghrelin levels of patients with ischemic and non-ischemic heart disease. Pericardial fluid and plasma samples were obtained from patients with coronary artery disease (ISCH, n=54) or valvular heart disease (VHD, n=41) undergoing cardiac surgery. Acylated pericardial ghrelin concentrations were found to be significantly higher in patients with ischemic heart disease (ISCH vs. VHD, 32±3 vs. 16±2pg/ml, p<0.01), whereas plasma levels of the peptide showed no difference between patient groups. Pericardial-to-plasma ratio, an index abolishing systemic effects on local ghrelin level was also significantly higher in ISCH group for both acylated and total ghrelin. Plasma total ghrelin showed negative correlation to BMI, plasma insulin and insulin resistance index HOMA-A. Pericardial acylated and total ghrelin concentrations were negatively correlated with posterior wall thickness (R=-0.31, p<0.05 and R=-0.35, p<0.01, respectively). Plasma insulin concentration and HOMA-A showed significant negative correlation with pericardial ghrelin levels. In conclusion, increased pericardial active ghrelin content and higher pericardial-to-plasma ghrelin ratio were found in ischemic heart disease as compared to non-ischemic patients suggesting an increased ghrelin production of the chronically ischemic myocardium. According to our results, pericardial ghrelin content is negatively influenced by left ventricular hypertrophy and insulin resistance.
authors.affiliation: Heart and Vascular Center, Semmelweis University, Budapest, Hungary. Electronic address: sax.balazs@kardio.sote.hu.
authors.forename: Balazs
authors.initials: B
authors.lastname: Sax
authors.forename: Béla
authors.initials: B
authors.lastname: Merkely
authors.forename: Katalin
authors.initials: K
authors.lastname: Túri
authors.forename: Andrea
authors.initials: A
authors.lastname: Nagy
authors.forename: Abdelkrim
authors.initials: A
authors.lastname: Ahres
authors.forename: István
authors.initials: I
authors.lastname: Hartyánszky
authors.forename: Tivadar
authors.initials: T
authors.lastname: Hüttl
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Szabolcs
authors.forename: Károly
authors.initials: K
authors.lastname: Cseh
authors.forename: Violetta
authors.initials: V
authors.lastname: Kékesi
mesh_terms: D000215:Acylation; D000368:Aged; D005260:Female; D054439:Ghrelin / Q000097:blood*; D006349:Heart Valve Diseases / Q000097:blood* / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000097:blood / Q000000981:diagnostic imaging / Q000503:physiopathology; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood* / Q000000981:diagnostic imaging / Q000503:physiopathology; D009206:Myocardium / Q000378:metabolism / Q000473:pathology; D009929:Organ Size; D010496:Pericardium / Q000378:metabolism*; D011499:Protein Processing, Post-Translational; D013318:Stroke Volume; D014463:Ultrasonography
chemical_list: D054439:Ghrelin
keywords: Ghrelin; Ischemic heart disease; Myocardium; Pericardial fluid; Valvular heart disease