Thomas Bochaton1,2, Jules Lassus3, Alexandre Paccalet1, François Derimay4, Gilles Rioufol4, Cyril Prieur2, Eric Bonnefoy-Cudraz2, Claire Crola Da Silva1, Hugo Bernelin2, Camille Amaz5, Sylvie Espanet5, Charles de Bourguignon5, Nathalie Dufay6, Régine Cartier7, Pierre Croisille8, Michel Ovize1,5,9, Nathan Mewton1,5. 1. INSERM U1060, CarMeN Laboratory, Université de Lyon, Groupement Hospitalier Est, Bron, France. 2. Unité de Soins Intensifs Cardiologiques, Hôpital Louis Pradel et Université Claude Bernard, Hospices Civils de Lyon, Bron, France. 3. Centre Hospitalier Universitaire de Martinique, Université des Antilles, Fort de France, France. 4. Department of Interventional Cardiology, Cardiovascular Hospital and Claude-Bernard University, Bron, France. 5. Centre d'investigation Clinique de Lyon, Hôpital Louis Pradel, Hospices Civils de Lyon, Bron, France. 6. NeuroBioTec, Groupement Hospitalier Est, Hôpital Neurologique Pierre Wertheimer, Bron, France. 7. Centre de biologie Est, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France. 8. Université de Lyon, Université Jean-Monnet Saint-Etienne, INSA, Centre National de la Recherche Scientifique, Unité Mixte de Recherche, Creatis, Saint-Etienne, France. 9. Service d'explorations Fonctionnelles Cardiovasculaires, Hôpital Louis Pradel, Hospices Civils de Lyon, Bron, France.
Abstract
INTRODUCTION: Myocardial hemorrhage (IMH) and persistent microvascular obstruction (MVO) are associated with impaired myocardial recovery and adverse clinical outcomes in STEMI patients. However, their relationship with circulating inflammatory biomarkers is unclear in human patients. METHODS AND RESULTS: Twenty consecutive patients referred for primary percutaneous coronary intervention of first STEMI were included in a prospective study. Blood sampling was performed at admission, 4, 12, 24, 48 hours, 7 and 30 days after reperfusion for inflammatory biomarker (C reactive protein, fibrinogen, interleukin-6 (IL-6) and neutrophils count) assessment. At seven days, cardiovascular magnetic resonance (CMR) was performed for infarct size, MVO and IMH assessment. Median infarct size was 24.6% Interquartile range (IQR) [12.0-43.5] of LV mass and edema was 13.2% IQR [7.7-36.1] of LV mass. IL-6 reached a peak at H24 (5.6 pg/mL interquartile range (IQR) [2.5-17.5]), CRP at H48 (11.7 mg/L IQR [7.1-69.2]), fibrinogen one week after admission (4.4 g/L IQR [3.8-6.7]) and neutrophils at H12 (9.0 G/L IQR [6.5-12.7]). MVO was present in 11 patients (55% of the study population) and hemorrhage in 7 patients (35%). Patients with IMH had significantly higher IL-6, CRP, fibrinogen, and neutrophils levels compared to patients without IMH. Patients with persistent MVO had significantly higher CRP, fibrinogen and neutrophils level compared to patients without MVO, but identical IL-6 kinetics. CONCLUSION: In human patients with acute myocardial infarction, intramyocardial hemorrhage appears to have a stronger relationship with inflammatory biomarker release compared to persistent MVO. Attenuating myocardial hemorrhage may be a novel target in future adjunctive STEMI treatments.
INTRODUCTION:Myocardial hemorrhage (IMH) and persistent microvascular obstruction (MVO) are associated with impaired myocardial recovery and adverse clinical outcomes in STEMI patients. However, their relationship with circulating inflammatory biomarkers is unclear in humanpatients. METHODS AND RESULTS: Twenty consecutive patients referred for primary percutaneous coronary intervention of first STEMI were included in a prospective study. Blood sampling was performed at admission, 4, 12, 24, 48 hours, 7 and 30 days after reperfusion for inflammatory biomarker (C reactive protein, fibrinogen, interleukin-6 (IL-6) and neutrophils count) assessment. At seven days, cardiovascular magnetic resonance (CMR) was performed for infarct size, MVO and IMH assessment. Median infarct size was 24.6% Interquartile range (IQR) [12.0-43.5] of LV mass and edema was 13.2% IQR [7.7-36.1] of LV mass. IL-6 reached a peak at H24 (5.6 pg/mL interquartile range (IQR) [2.5-17.5]), CRP at H48 (11.7 mg/L IQR [7.1-69.2]), fibrinogen one week after admission (4.4 g/L IQR [3.8-6.7]) and neutrophils at H12 (9.0 G/L IQR [6.5-12.7]). MVO was present in 11 patients (55% of the study population) and hemorrhage in 7 patients (35%). Patients with IMH had significantly higher IL-6, CRP, fibrinogen, and neutrophils levels compared to patients without IMH. Patients with persistent MVO had significantly higher CRP, fibrinogen and neutrophils level compared to patients without MVO, but identical IL-6 kinetics. CONCLUSION: In humanpatients with acute myocardial infarction, intramyocardial hemorrhage appears to have a stronger relationship with inflammatory biomarker release compared to persistent MVO. Attenuating myocardial hemorrhage may be a novel target in future adjunctive STEMI treatments.
Authors: Avinash Kali; Ivan Cokic; Richard Tang; Alice Dohnalkova; Libor Kovarik; Hsin-Jung Yang; Andreas Kumar; Frank S Prato; John C Wood; David Underhill; Eduardo Marbán; Rohan Dharmakumar Journal: Circ Cardiovasc Imaging Date: 2016-11 Impact factor: 7.792
Authors: Christoph Liebetrau; Holger M Nef; Oliver Dörr; Luise Gaede; Jedrzej Hoffmann; Astrid Hahnel; Andreas Rolf; Christian Troidl; Karl J Lackner; Till Keller; Christian W Hamm; Helge Möllmann Journal: Heart Date: 2014-01-31 Impact factor: 5.994
Authors: Borja Ibanez; Stefan James; Stefan Agewall; Manuel J Antunes; Chiara Bucciarelli-Ducci; Héctor Bueno; Alida L P Caforio; Filippo Crea; John A Goudevenos; Sigrun Halvorsen; Gerhard Hindricks; Adnan Kastrati; Mattie J Lenzen; Eva Prescott; Marco Roffi; Marco Valgimigli; Christoph Varenhorst; Pascal Vranckx; Petr Widimský Journal: Eur Heart J Date: 2018-01-07 Impact factor: 29.983
Authors: C P Gale; V Allan; B A Cattle; A S Hall; R M West; A Timmis; H H Gray; J Deanfield; K A A Fox; R Feltbower Journal: Heart Date: 2014-01-16 Impact factor: 5.994