ISSN: 1449-2288International Journal of Biological Sciences
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Int J Biol Sci 2015; 11(1):38-47. doi:10.7150/ijbs.10271 This issue Cite
Research Paper
Decrease in Plasma Cyclophilin A Concentration at 1 Month after Myocardial Infarction Predicts Better Left Ventricular Performance and Synchronicity at 6 Months: A Pilot Study in Patients with ST Elevation Myocardial Infarction
1. Division of Cardiology, Department of Internal Medicine, Changhua Christian Hospital, Changhua 500, Taiwan
2. Department of Biological Science and Technology, National Chiao Tung University, Hsinchu 300, Taiwan
3. Division of Nephrology, Department of Internal Medicine, Changhua Christian Hospital, Changhua 500, Taiwan
4. School of Medicine, Chung Shan Medical University, Taichung 404, Taiwan
5. Vascular and Genomic Research Center, Changhua Christian Hospital, Changhua 500, Taiwan
6. Department of Neurology, Changhua Christian Hospital, Changhua 500, Taiwan
7. Graduate Institute of Integrative Medicine, China Medical University, Taichung 404, Taiwan
* These authors contributed equally to the manuscript.
Abstract
Background: Cyclophilin A (CyPA) concentration increases in acute coronary syndrome. In an animal model of acute myocardial infarction, administration of angiotensin-converting-enzyme inhibitor was associated with lower left ventricular (LV) CyPA concentration and improved LV performance. This study investigated the relationships between changes in plasma CyPA concentrations and LV remodeling in patients with ST-elevation myocardial infarction (STEMI).
Methods and Results: We enrolled 55 patients who underwent percutaneous coronary intervention for acute STEMI. Plasma CyPA, matrix metalloproteinase (MMP), interleukin-6 and high-sensitivity C-reactive protein concentrations were measured at baseline and at one-month follow-up. Echocardiography was performed at baseline and at one-, three-, and six-month follow-up. Patients with a decrease in baseline CyPA concentration at one-month follow-up (n = 28) had a significant increase in LV ejection fraction (LVEF) (from 60.2 ± 11.5% to 64.6 ± 9.9%, p < 0. 001) and preserved LV synchrony at six months. Patients without a decrease in CyPA concentration at one month (n = 27) did not show improvement in LVEF and had a significantly increased systolic dyssynchrony index (SDI) (from 1.170 ± 0.510% to 1.637 ± 1.299%, p = 0.042) at six months. Multiple linear regression analysis showed a significant association between one-month CyPA concentration and six-month LVEF. The one-month MMP-2 concentration was positively correlated with one-month CyPA concentration and LV SDI.
Conclusions: Decreased CyPA concentration at one-month follow-up after STEMI was associated with better LVEF and SDI at six months. Changes in CyPA, therefore, may be a prognosticator of patient outcome.
Keywords: Acute myocardial infarction, Cyclophilin A, Left ventricular ejection fraction, Left ventricular dyssynchrony, Matrix metalloproteinase.
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