title: Myocardial infarction induces atrial inflammation that can be prevented by C1-esterase inhibitor.
abstract: OBJECTIVE
  Inflammation plays an important role in the pathogenesis of myocardial infarction (MI). Whether MI induces atrial inflammation is unknown however. Here, we analysed atrial inflammation in patients with MI and in rats with experimentally induced MI. The effect of the anti-inflammatory agent C1-esterase inhibitor (C1inh) on atrial inflammation in rats was also analysed.
  
  
  METHODS
  In the hearts of patients who died at different time points after MI (total n=24, mean age=60), neutrophils (myeloperoxidase-positive cells), lymphocytes (CD45-positive cells) and macrophages (CD68-positive cells) were quantified in the myocardium of the left and right atria and the infarcted left and non-infarcted right ventricles and compared with control patients (n=5, mean age=59). For the left and right atria, inflammatory cells were also quantified in the atrial adipose tissue. MI was induced in 17 rats, of which 10 were subsequently treated with C1inh for 6 days. Forty-two days post-MI, lymphocytes, macrophages and the endothelial inflammation marker Nε-(carboxymethyl)lysine (CML) were analysed in the myocardium of both the atria and ventricles.
  
  
  RESULTS
  In all investigated areas of the human hearts increased lymphocytes and macrophages were observed to a varying extent, especially between 6 h and 5 days following MI. Similarly, in rats MI resulted in an increase of inflammatory cells and CML in the atria. C1inh treatment decreased atrial inflammation.
  
  
  CONCLUSIONS
  MI induces atrial inflammation in patients and in rats. C1inh treatment could counteract this MI-induced atrial inflammation in rats.
authors.affiliation: Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands.|ICaR-VU, Amsterdam, The Netherlands.|Netherlands Forensic Institute (NFI), The Hague, The Netherlands.
authors.forename: Mark Pv
authors.initials: MP
authors.lastname: Begieneman
authors.affiliation: Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands.|ICaR-VU, Amsterdam, The Netherlands.|Department of Immunopathology, Sanquin Research, Amsterdam, The Netherlands.
authors.forename: Reindert W
authors.initials: RW
authors.lastname: Emmens
authors.affiliation: Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Liza
authors.initials: L
authors.lastname: Rijvers
authors.affiliation: Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands.|ICaR-VU, Amsterdam, The Netherlands.
authors.forename: Linde
authors.initials: L
authors.lastname: Woudstra
authors.affiliation: ICaR-VU, Amsterdam, The Netherlands.|Department of Physiology, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Walter J
authors.initials: WJ
authors.lastname: Paulus
authors.affiliation: Netherlands Forensic Institute (NFI), The Hague, The Netherlands.
authors.forename: Bela
authors.initials: B
authors.lastname: Kubat
authors.affiliation: ICaR-VU, Amsterdam, The Netherlands.|Department of Cardiac Surgery, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Alexander Ba
authors.initials: AB
authors.lastname: Vonk
authors.affiliation: ICaR-VU, Amsterdam, The Netherlands.|Department of Cardiology, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Albert C
authors.initials: AC
authors.lastname: van Rossum
authors.affiliation: Department of Immunopathology, Sanquin Research, Amsterdam, The Netherlands.
authors.forename: Diana
authors.initials: D
authors.lastname: Wouters
authors.affiliation: Department of Immunopathology, Sanquin Research, Amsterdam, The Netherlands.|Department of Hematology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Sacha
authors.initials: S
authors.lastname: Zeerleder
authors.affiliation: Department of Immunopathology, Sanquin Research, Amsterdam, The Netherlands.
authors.forename: Marieke
authors.initials: M
authors.lastname: van Ham
authors.affiliation: Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Casper G
authors.initials: CG
authors.lastname: Schalkwijk
authors.affiliation: Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands.|ICaR-VU, Amsterdam, The Netherlands.|Department of Cardiac Surgery, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Hans Wm
authors.initials: HW
authors.lastname: Niessen
authors.affiliation: Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands.|ICaR-VU, Amsterdam, The Netherlands.
authors.forename: Paul Aj
authors.initials: PA
authors.lastname: Krijnen
mesh_terms: D000818:Animals; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D050718:Complement C1 Inhibitor Protein / Q000627:therapeutic use*; D003331:Coronary Vessels / Q000473:pathology; D004195:Disease Models, Animal; D006325:Heart Atria / Q000473:pathology*; D006352:Heart Ventricles / Q000473:pathology; D006801:Humans; D007249:Inflammation / Q000188:drug therapy; D008214:Lymphocytes / Q000473:pathology; D008264:Macrophages / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000473:pathology; D009206:Myocardium / Q000473:pathology; D009504:Neutrophils / Q000473:pathology; D051381:Rats; D017208:Rats, Wistar
chemical_list: D000893:Anti-Inflammatory Agents; D050718:Complement C1 Inhibitor Protein
keywords: HEART; INFLAMMATION; LEUCOCYTES