title: Blood PGC-1α Concentration Predicts Myocardial Salvage and Ventricular Remodeling After ST-segment Elevation Acute Myocardial Infarction.
abstract: OBJECTIVE
  Peroxisome proliferator-activated receptor gamma coactivator 1α (PGC-1α) is a metabolic regulator induced during ischemia that prevents cardiac remodeling in animal models. The activity of PGC-1α can be estimated in patients with ST-segment elevation acute myocardial infarction. The aim of the present study was to evaluate the value of blood PGC-1α levels in predicting the extent of necrosis and ventricular remodeling after infarction.
  
  
  METHODS
  In this prospective study of 31 patients with a first myocardial infarction in an anterior location and successful reperfusion, PGC-1α expression in peripheral blood on admission and at 72 hours was correlated with myocardial injury, ventricular volume, and systolic function at 6 months. Edema and myocardial necrosis were estimated using cardiac magnetic resonance imaging during the first week. At 6 months, infarct size and ventricular remodeling, defined as an increase > 10% of the left ventricular end-diastolic volume, was evaluated by follow-up magnetic resonance imaging. Myocardial salvage was defined as the difference between the edema and necrosis areas.
  
  
  RESULTS
  Greater myocardial salvage was seen in patients with detectable PGC-1α levels at admission (mean [standard deviation (SD)], 18.3% [5.3%] vs 4.5% [3.9%]; P = .04). Induction of PGC-1α at 72 hours correlated with greater ventricular remodeling (change in left ventricular end-diastolic volume at 6 months, 29.7% [11.2%] vs 1.2% [5.8%]; P = .04).
  
  
  CONCLUSIONS
  Baseline PGC-1α expression and an attenuated systemic response after acute myocardial infarction are associated with greater myocardial salvage and predict less ventricular remodeling.
authors.affiliation: Servicio de Cardiología, Consorcio Hospital General Universitario de Valencia, Valencia, Spain; Fundación de Investigación, Hospital General de Valencia, Valencia, Spain. Electronic address: osfabregat@gmail.com.
authors.forename: Óscar
authors.initials: Ó
authors.lastname: Fabregat-Andrés
authors.affiliation: Servicio de Cardiología, Consorcio Hospital General Universitario de Valencia, Valencia, Spain; Departamento de Medicina, Universitat de València, Valencia, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Ridocci-Soriano
authors.affiliation: Unidad de Imagen Cardiaca, ERESA, Hospital General Universitario de Valencia, Valencia, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Estornell-Erill
authors.affiliation: Departamento de Cardiología, Complejo Hospitalario de Albacete, Albacete, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Corbí-Pascual
authors.affiliation: Departamento de Cardiología, Hospital Marina Salud, Denia, Alicante, Spain.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Valle-Muñoz
authors.affiliation: Servicio de Cardiología, Consorcio Hospital General Universitario de Valencia, Valencia, Spain.
authors.forename: Alberto
authors.initials: A
authors.lastname: Berenguer-Jofresa
authors.affiliation: Departamento de Cardiología, Hospital Universitario Vall d'Hebron, Barcelona, Spain; Departamento de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: José A
authors.initials: JA
authors.lastname: Barrabés
authors.affiliation: Departamento de Patología, Facultad de Medicina, Universitat de València, Valencia, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Mata
authors.affiliation: Departamento de Metabolismo y Señalización Celular, Instituto de Investigaciones Biomédicas Alberto Sols (CSIC-UAM), Madrid, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Monsalve
mesh_terms: D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006360:Heat-Shock Proteins; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000473:pathology / Q000503:physiopathology; D009206:Myocardium / Q000473:pathology*; D000071248:Peroxisome Proliferator-Activated Receptor Gamma Coactivator 1-alpha; D011379:Prognosis; D011446:Prospective Studies; D013318:Stroke Volume; D014157:Transcription Factors / Q000097:blood*; D020257:Ventricular Remodeling / Q000502:physiology*
chemical_list: D006360:Heat-Shock Proteins; C486497:PPARGC1A protein, human; D000071248:Peroxisome Proliferator-Activated Receptor Gamma Coactivator 1-alpha; D014157:Transcription Factors
keywords: Estrés oxidativo; Infarto agudo de miocardio con elevación del segmento ST; Metabolismo oxidativo; Oxidative metabolism; Oxidative stress; PGC-1α; Remodelado ventricular; ST-segment elevation acute myocardial infarction; Ventricular remodeling