Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2015;68:408-16 - Vol. 68 Num.05 DOI: 10.1016/j.rec.2014.05.020

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

Óscar Fabregat-Andrés a,b,, Francisco Ridocci-Soriano a,c, Jordi Estornell-Erill d, Miguel Corbí-Pascual e, Alfonso Valle-Muñoz f, Alberto Berenguer-Jofresa a, José A. Barrabés g,h, Manuel Mata i, María Monsalve j

a Servicio de Cardiología, Consorcio Hospital General Universitario de Valencia, Valencia, Spain
b Fundación de Investigación, Hospital General de Valencia, Valencia, Spain
c Departamento de Medicina, Universitat de València, Valencia, Spain
d Unidad de Imagen Cardiaca, ERESA, Hospital General Universitario de Valencia, Valencia, Spain
e Departamento de Cardiología, Complejo Hospitalario de Albacete, Albacete, Spain
f Departamento de Cardiología, Hospital Marina Salud, Denia, Alicante, Spain
g Departamento de Cardiología, Hospital Universitario Vall d’Hebron, Barcelona, Spain
h Departamento de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
i Departamento de Patología, Facultad de Medicina, Universitat de València, Valencia, Spain
j Departamento de Metabolismo y Señalización Celular, Instituto de Investigaciones Biomédicas Alberto Sols (CSIC-UAM), Madrid, Spain

Keywords

PGC-1α. ST-segment elevation acute myocardial infarction. Ventricular remodeling. Oxidative metabolism. Oxidative stress.

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.

1885-5857/© 2015 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

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