Óscar Fabregat-Andrés1, Francisco Ridocci-Soriano2, Jordi Estornell-Erill3, Miguel Corbí-Pascual4, Alfonso Valle-Muñoz5, Alberto Berenguer-Jofresa6, José A Barrabés7, Manuel Mata8, María Monsalve9. 1. 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. 2. Servicio de Cardiología, Consorcio Hospital General Universitario de Valencia, Valencia, Spain; Departamento de Medicina, Universitat de València, Valencia, Spain. 3. Unidad de Imagen Cardiaca, ERESA, Hospital General Universitario de Valencia, Valencia, Spain. 4. Departamento de Cardiología, Complejo Hospitalario de Albacete, Albacete, Spain. 5. Departamento de Cardiología, Hospital Marina Salud, Denia, Alicante, Spain. 6. Servicio de Cardiología, Consorcio Hospital General Universitario de Valencia, Valencia, Spain. 7. Departamento de Cardiología, Hospital Universitario Vall d'Hebron, Barcelona, Spain; Departamento de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain. 8. Departamento de Patología, Facultad de Medicina, Universitat de València, Valencia, Spain. 9. Departamento de Metabolismo y Señalización Celular, Instituto de Investigaciones Biomédicas Alberto Sols (CSIC-UAM), Madrid, Spain.
Abstract
INTRODUCTION AND OBJECTIVES: 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.
INTRODUCTION AND OBJECTIVES: 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: Damien Legallois; Amir Hodzic; Joachim Alexandre; Charles Dolladille; Eric Saloux; Alain Manrique; Vincent Roule; Fabien Labombarda; Paul Milliez; Farzin Beygui Journal: Heart Fail Rev Date: 2022-01 Impact factor: 4.214
Authors: Oscar Fabregat-Andres; Federico Paredes; María Monsalve; Javier Milara; Francisco Ridocci-Soriano; Sonia Gonzalez-Hervas; Armando Mena; Lorenzo Facila; Fernando Hornero; Salvador Morell; Juan Martinez-Leon; Julio Cortijo Journal: Anatol J Cardiol Date: 2015-11-26 Impact factor: 1.596