Serum C-reactive protein elevation in left ventricular remodeling after acute myocardial infarction - Role of neurohormones and cytokines

Toshiyuki Takahashi, Toshihisa Anzai, Tsutomu Yoshikawa, Yuichiro Maekawa, Yasushi Asakura, Toru Satoh, Hideo Mitamura, Satoshi Ogawa

Research output: Contribution to journalArticle

49 Citations (Scopus)

Abstract

Background: We previously reported that increased peak serum C-reactive protein (CRP) level after acute myocardial infarction (AMI) was a major predictor of cardiac rupture and long-term outcome. The aim of this study was to clarify the role of serum CRP elevation as a possible marker of left ventricular (LV) remodeling after AMI. Methods: We prospectively studied 31 patients who underwent primary angioplasty for a first anterior Q-wave AMI. Peak serum CRP level was determined by serial measurements after admission. LV volume and the plasma levels of various neurohormones and cytokines were measured on admission, and 2 weeks and 6 months after AMI. Results: Patients with higher peak CRP levels (above the median) had a greater increase in LV end-diastolic volume during 2 weeks after AMI (+21±14 vs. +5±6 ml/m2, P=0.001) and a lower ejection fraction (45±11 vs. 53±7%, P=0.02) than those with lower CRP levels, associated with a higher incidence of pump failure, atrial fibrillation, and LV aneurysm. Plasma levels of norepinephrine, brain natriuretic peptide, and interleukin-6 2 weeks after AMI were higher in the high CRP group than in the low CRP group. Conclusions: Increased peak serum CRP level was associated with a greater increase in LV volume after anterior AMI. Plasma norepinephrine and interleukin-6 levels were increased in patients with higher CRP levels, suggesting a possible role of sympathetic activation and enhanced immune response in the development of LV remodeling after AMI.

Original languageEnglish
Pages (from-to)257-265
Number of pages9
JournalInternational Journal of Cardiology
Volume88
Issue number2-3
DOIs
Publication statusPublished - 2003 Apr

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Ventricular Remodeling
C-Reactive Protein
Neurotransmitter Agents
Blood Proteins
Myocardial Infarction
Cytokines
Interleukin-6
Norepinephrine
Heart Rupture
Plasma Volume
Brain Natriuretic Peptide
Angioplasty
Stroke Volume
Atrial Fibrillation
Interleukin-2
Aneurysm
Incidence

Keywords

  • Angioplasty
  • Cytokine
  • Inflammatory response
  • Neurohormone
  • Sympathetic activation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Serum C-reactive protein elevation in left ventricular remodeling after acute myocardial infarction - Role of neurohormones and cytokines. / Takahashi, Toshiyuki; Anzai, Toshihisa; Yoshikawa, Tsutomu; Maekawa, Yuichiro; Asakura, Yasushi; Satoh, Toru; Mitamura, Hideo; Ogawa, Satoshi.

In: International Journal of Cardiology, Vol. 88, No. 2-3, 04.2003, p. 257-265.

Research output: Contribution to journalArticle

Takahashi, Toshiyuki ; Anzai, Toshihisa ; Yoshikawa, Tsutomu ; Maekawa, Yuichiro ; Asakura, Yasushi ; Satoh, Toru ; Mitamura, Hideo ; Ogawa, Satoshi. / Serum C-reactive protein elevation in left ventricular remodeling after acute myocardial infarction - Role of neurohormones and cytokines. In: International Journal of Cardiology. 2003 ; Vol. 88, No. 2-3. pp. 257-265.
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AU - Maekawa, Yuichiro

AU - Asakura, Yasushi

AU - Satoh, Toru

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AB - Background: We previously reported that increased peak serum C-reactive protein (CRP) level after acute myocardial infarction (AMI) was a major predictor of cardiac rupture and long-term outcome. The aim of this study was to clarify the role of serum CRP elevation as a possible marker of left ventricular (LV) remodeling after AMI. Methods: We prospectively studied 31 patients who underwent primary angioplasty for a first anterior Q-wave AMI. Peak serum CRP level was determined by serial measurements after admission. LV volume and the plasma levels of various neurohormones and cytokines were measured on admission, and 2 weeks and 6 months after AMI. Results: Patients with higher peak CRP levels (above the median) had a greater increase in LV end-diastolic volume during 2 weeks after AMI (+21±14 vs. +5±6 ml/m2, P=0.001) and a lower ejection fraction (45±11 vs. 53±7%, P=0.02) than those with lower CRP levels, associated with a higher incidence of pump failure, atrial fibrillation, and LV aneurysm. Plasma levels of norepinephrine, brain natriuretic peptide, and interleukin-6 2 weeks after AMI were higher in the high CRP group than in the low CRP group. Conclusions: Increased peak serum CRP level was associated with a greater increase in LV volume after anterior AMI. Plasma norepinephrine and interleukin-6 levels were increased in patients with higher CRP levels, suggesting a possible role of sympathetic activation and enhanced immune response in the development of LV remodeling after AMI.

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