Post-Reperfusion Enhancement of CD14+CD16- Monocytes and Microvascular Obstruction in ST-Segment Elevation Acute Myocardial Infarction

Hiroto Tsujioka; Toshio Imanishi; Hideyuki Ikejima; Takashi Tanimoto; Akio Kuroi; Manabu Kashiwagi; Keishi Okochi; Kohei Ishibashi; Kenichi Komukai; Yasushi Ino; Hironori Kitabata; Takashi Akasaka

doi:10.1253/circj.CJ-09-1045

Ischemic Heart Disease

Post-Reperfusion Enhancement of CD14⁺CD16^- Monocytes and Microvascular Obstruction in ST-Segment Elevation Acute Myocardial Infarction

Hiroto Tsujioka, Toshio Imanishi, Hideyuki Ikejima, Takashi Tanimoto, Akio Kuroi, Manabu Kashiwagi, Keishi Okochi, Kohei Ishibashi, Kenichi Komukai, Yasushi Ino, Hironori Kitabata, Takashi Akasaka

Author information

Hiroto Tsujioka
Department of Cardiovascular Medicine, Wakayama Medical University
Toshio Imanishi
Department of Cardiovascular Medicine, Wakayama Medical University
Hideyuki Ikejima
Department of Cardiovascular Medicine, Wakayama Medical University
Takashi Tanimoto
Department of Cardiovascular Medicine, Wakayama Medical University
Akio Kuroi
Department of Cardiovascular Medicine, Wakayama Medical University
Manabu Kashiwagi
Department of Cardiovascular Medicine, Wakayama Medical University
Keishi Okochi
Department of Cardiovascular Medicine, Wakayama Medical University
Kohei Ishibashi
Department of Cardiovascular Medicine, Wakayama Medical University
Kenichi Komukai
Department of Cardiovascular Medicine, Wakayama Medical University
Yasushi Ino
Department of Cardiovascular Medicine, Wakayama Medical University
Hironori Kitabata
Department of Cardiovascular Medicine, Wakayama Medical University
Takashi Akasaka
Department of Cardiovascular Medicine, Wakayama Medical University

Keywords: Acute myocardial infarction, Cardiovascular magnetic resonance, Microvascular obstruction, Monocyte

JOURNAL FREE ACCESS

2010 Volume 74 Issue 6 Pages 1175-1182

DOI https://doi.org/10.1253/circj.CJ-09-1045

View "Advance Publication" version (April 27, 2010).

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Abstract

Background: The presence of microvascular obstruction (MVO) after primary ST-segment elevation acute myocardial infarction (STEMI) is associated with a poor outcome. The aim of the paper was to examine the relationship between distinct monocyte subsets and gadolinium-enhanced cardiovascular magnetic resonance (CMR) characteristics of MVO after STEMI. Methods and Results: Seventy-one patients with primary STEMI successfully treated with stenting were enrolled in the study. Two monocyte subsets (CD14⁺CD16^- and CD14⁺CD16⁺) were measured on flow cytometry on admission and 2, 3, 4, 5, 8 days after the onset of STEMI. CMR was performed 7 days after revascularization to determine MVO on late gadolinium-enhanced imaging. The peak levels of CD14⁺CD16^- monocytes, but not those of CD14⁺CD16⁺ monocytes, were significantly higher in patients with MVO than in those without MVO. A multivariate logistic regression model showed that the post-perfusion peak levels of CD14⁺CD16^- monocytes remained an independent factor for the presence of MVO (odds ratio=1.53; 95% confidence interval: 1.01-2.32; P=0.04). The absence of MVO was significantly associated with improvement in left ventricular ejection fraction. Conclusions: Post-reperfusion enhancement of CD14⁺CD16^- monocytes was associated with MVO in patients with STEMI. The pathophysiologic and therapeutic implications of this association require further study. (Circ J 2010; 74: 1175 - 1182)

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