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Rev Esp Cardiol (Engl Ed). 2015 May;68(5):408-16. doi: 10.1016/j.rec.2014.05.020. Epub 2014 Nov 5.

Blood PGC-1α Concentration Predicts Myocardial Salvage and Ventricular Remodeling After ST-segment Elevation Acute Myocardial Infarction.

Author information

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.

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

PMID:
25440044
DOI:
10.1016/j.rec.2014.05.020
[Indexed for MEDLINE]

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