title: Dynamics of serum-induced endothelial cell apoptosis in patients with myocardial infarction.
abstract: BACKGROUND
  In patients with ST-segment elevation myocardial infarction (STEMI) reperfused with primary coronary intervention (PCI), the dynamics of endothelial cell (EC) viability, apoptosis and necrosis and its relationship with the structural consequences on the left ventricle have not been addressed so far.
  
  
  METHODS
  In 20 STEMI patients, we incubated human umbilical vein endothelial cells (HUVECs) with serum drawn before reperfusion and subsequently afterwards (24, 96 h, 30 days). Viability, apoptosis and necrosis percentages were evaluated by flow cytometry. Values were compared with 12 age- and sex-matched control subjects with normal coronary arteries. Cardiac magnetic resonance (CMR) was performed during the first week after infarction.
  
  
  RESULTS
  Serum from STEMI patients induced a progressive loss of EC viability, with a nadir of 67.7 ± 10.2% at 96 h (baseline: 75 ± 6% and controls: 80.2 ± 3.9%, P < 0.001 in both cases). This is due to an increase in apoptosis that peaked at 96 h after reperfusion (15.2 ± 7.1% vs. 11 ± 6 at baseline and 5.8 ± 1.6% in controls, P < 0.001 in both cases). However, no significant dynamic changes in EC necrosis were detected. Extensive myocardial oedema (> 30%, median of left ventricular mass) was the only CMR variable significantly associated with a higher percentage of EC apoptosis at 96 h (extensive vs. nonextensive oedema: 18.3 ± 6.8% vs. 12.1 ± 6.3%, P < 0.05).
  
  
  CONCLUSIONS
  Dynamic changes in EC viability occur in the setting of STEMI patients reperfused with PCI, these changes peak late after reperfusion, they are mainly the result of an increase of apoptosis and are associated with the presence of extensive myocardial oedema.
authors.affiliation: Cardiology Department, Hospital Clínico Universitario, Valencia, Spain; Universidad de Valencia, Valencia, Spain; INCLIVA, Fundación Hospital Clínico Universitario de Valencia, Valencia, Spain.
authors.forename: Maria J
authors.initials: MJ
authors.lastname: Forteza
authors.forename: Susana
authors.initials: S
authors.lastname: Novella
authors.forename: Isabel
authors.initials: I
authors.lastname: Trapero
authors.forename: Carlos
authors.initials: C
authors.lastname: Hermenegildo
authors.forename: Amparo
authors.initials: A
authors.lastname: Ruiz-Sauri
authors.forename: Fabian
authors.initials: F
authors.lastname: Chaustre
authors.forename: Clara
authors.initials: C
authors.lastname: Bonanad
authors.forename: Ricardo
authors.initials: R
authors.lastname: Oltra
authors.forename: Lorena
authors.initials: L
authors.lastname: Palacios
authors.forename: J Enrique
authors.initials: JE
authors.lastname: O'Connor
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Chorro
authors.forename: Vicente
authors.initials: V
authors.lastname: Bodi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017209:Apoptosis / Q000502:physiology*; D057791:Cardiac Imaging Techniques; D016022:Case-Control Studies; D002470:Cell Survival / Q000502:physiology; D042783:Endothelial Cells / Q000502:physiology*; D005260:Female; D061307:Human Umbilical Vein Endothelial Cells; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology* / Q000628:therapy; D009336:Necrosis / Q000503:physiopathology; D062645:Percutaneous Coronary Intervention; D044967:Serum / Q000502:physiology*
keywords: Acute myocardial infarction; apoptosis; endothelial cells; magnetic resonance