Soluble IL-1 receptor 2 is associated with left ventricular remodelling in patients with ST-elevation myocardial infarction.

The inflammatory response following myocardial infarction (MI) is prerequisite for proper healing of infarcted tissue, but can also have detrimental effects on cardiac function. Interleukin (IL)-1α and IL-1β are potent inflammatory mediators and their bioactivity is tightly regulated by IL-1 receptor antagonist (IL-1ra) and soluble (s) IL-1 receptors (R). We aimed to examine whether levels of soluble regulators of IL-1 signalling are changed during ST-elevation MI (STEMI) and their associations with parameters of cardiac injury and ventricular remodelling. Plasma levels of IL-1Ra, sIL-1R1, sIL-1R2 and sIL-1R accessory protein (sIL-1RAcP) were measured by immunoassays in repeated samples from patients with STEMI (n = 255) and compared to healthy controls (n = 65). IL-1Ra, sIL-1R1 and sIL-1R2 levels were all significantly elevated after STEMI, while levels of sIL-1RAcP were lower compared to controls. sIL-1R2 levels (at different time points) correlated positively with C-reactive protein, myocardial infarct size and change in indexed left ventricular end-diastolic and end-systolic volume (LVEDVi and LVESVi) measured by cardiac MR acutely and after 4 months, and negatively with LV ejection fraction. Patients with >median levels of sIL-1R2 in the acute phase were more likely to have increased change in LVEDVi and LVESVi. Importantly, sIL-1R2 remained significantly associated with change in LVEDVi and LVESVi also after adjustment for clinical covariates. Levels of sIL-1R2 are independently associated with parameters of LV adverse remodelling following STEMI.

Orrem HL ，Shetelig C ，Ueland T ，Limalanathan S ，Nilsson PH ，Husebye T ，Aukrust P ，Seljeflot I ，Hoffmann P ，Eritsland J ，Mollnes TE ，Andersen GØ ，Yndestad A ... -  《-》

Increased interleukin-1β levels are associated with left ventricular hypertrophy and remodelling following acute ST segment elevation myocardial infarction treated by primary percutaneous coronary intervention.

To assess the relationship between interleukin (IL)-1-related molecules, infarct size and left ventricular (LV) remodelling following acute myocardial infarction (MI). Forty-two patients with first-time diagnosis of ST segment elevation MI (STEMI), with a single occluded vessel successfully revascularized by primary percutaneous coronary intervention (PCI), were recruited to this observational study conducted at a university teaching hospital and followed for 1 year. Plasma levels of IL-1β, IL-1 receptor antagonist (IL-1Ra), IL-18 and caspase-1 were analysed before and 2 days, 1 week and 2 months after PCI. Serial cardiac magnetic resonance imaging (CMR) was used for the assessment of infarct size and LV remodelling. CMR findings at 1 year was the primary outcome variable. Univariate analysis showed that IL-1-related mediators were strongly (IL-1 β), moderately (caspase-1) and weakly (IL-1Ra) associated with impaired myocardial function and noninfarct mass, but not infarct size, 1 year after reperfused STEMI. In multivariate analyses, troponin T predicted LV ejection fraction (LVEF), infarct size and LV end-diastolic (LVEDVi) and end-systolic volume index (LVESVi). However, significant additional variance was explained by IL-1β, IL-18 and caspase-1. IL-1β levels at 2 months, IL-18 at 2 days and pre-PCI caspase-1 were predictors of LVEF. Caspase-1 and in particular IL-1β at 2 days were the only predictors of noninfarct mass. IL-1β and IL-18 at 2 days were predictors of LVEDVi, whilst pre-PCI levels of IL-1β contributed to prediction of LVESVi. By contrast, pro-B-type natriuretic peptide, C-reactive protein, IL-6 and transforming growth factor-β1 (TGF-β1) had no or only a weak (TGF-β1) association with these CMR parameters in multivariate analyses. IL-1β levels after STEMI were strongly associated with impaired myocardial function and noninfarct LV mass after 1 year, suggesting a potential role for IL-1β as a predictor of maladaptive myocardial remodelling following reperfused MI.

Ørn S ，Ueland T ，Manhenke C ，Sandanger Ø ，Godang K ，Yndestad A ，Mollnes TE ，Dickstein K ，Aukrust P ... -  《-》

Plasma interleukin 6 levels are associated with cardiac function after ST-elevation myocardial infarction.

Groot HE ，Al Ali L ，van der Horst ICC ，Schurer RAJ ，van der Werf HW ，Lipsic E ，van Veldhuisen DJ ，Karper JC ，van der Harst P ... -  《-》

Predictors of left ventricular remodeling after ST-elevation myocardial infarction.

Hendriks T ，Hartman MHT ，Vlaar PJJ ，Prakken NHJ ，van der Ende YMY ，Lexis CPH ，van Veldhuisen DJ ，van der Horst ICC ，Lipsic E ，Nijveldt R ，van der Harst P ... -  《-》

ST2 and left ventricular remodeling after ST-segment elevation myocardial infarction: A cardiac magnetic resonance study.

The association of soluble interleukin-1 receptor-like 1 (ST2) with left ventricular (LV) remodeling is unclear in patients with a first ST-segment elevation myocardial infarction (STEMI). The objective of this work was to assess the relationship between ST2, a marker of inflammation, and cardiac magnetic resonance (CMR) imaging-derived LV remodeling after a first STEMI. We prospectively evaluated 109 patients with a first STEMI treated with primary percutaneous coronary intervention who had ST2 assessed 24 h post-reperfusion. All patients underwent CMR imaging 1 week and 6 months after STEMI. The independent associations between ST2, LV diastolic and systolic volume indices, and LV ejection fraction (LVEF) were evaluated by linear mixed models. The mean age of the sample was 59 ± 12 years, 85 patients (78%) were male, and 13 (11.9%) had a LVEF ≤40%. The median (IQR) of ST2 was 55.3 (38.7-94.1) pg/mL. At 1-week CMR higher ST2 was related to more infarct size and less myocardial salvage index (p < 0.01). Overall, after comprehensive multivariable adjustment, higher baseline ST2 was associated with progressive LV volume indices dilation and LVEF deterioration (p < 0.05). This effect was stronger in patients with severe 1-week structural damage, namely those with large infarct size, extensive microvascular obstruction or LVEF ≤40%. In patients with a first STEMI treated with primary percutaneous coronary intervention, soluble ST2 predicts dynamic changes in CMR-derived LV volumes and LVEF. Future studies must assess whether targeting interleukin-1 leads to lower ST2 levels and less LV remodeling.

Miñana G ，Núñez J ，Bayés-Genís A ，Revuelta-López E ，Ríos-Navarro C ，Núñez E ，Chorro FJ ，López-Lereu MP ，Monmeneu JV ，Lupón J ，Bodí V ... -  《-》