Increased levels of laminin and collagen type VI may reflect early remodelling in patients with acute myocardial infarction.

摘要

OBJECTIVE: The development of left ventricular remodelling (LVR) after acute myocardial infarction (AMI) is a predictor of heart failure and mortality. The extracellular matrix (ECM) is highly susceptible to ischaemic injury. Laminin and collagen type VI (CVI) contribute to ECM formation in the infarct zone. To determine whether these markers can be detected in blood samples, we measured laminin and CVI in patients with AMI and control subjects. METHODS: A total of 60 patients scheduled for coronary angiography and 31 patients with AMI were included. We subdivided the patients into three groups: (1) AMI, (2) stable coronary artery disease (CAD) and (3) exclusion of CAD. Laminin and CVI serum concentrations were recorded using the ELISA-technique. RESULTS: Laminin was significantly higher in patients with AMI than in subjects with stable CAD (36.5 vs. 23.9, P < 0.01) or without CAD (36.5 vs. 24.6 ng/ml, P < 0.05). CVI-levels were significantly elevated in patients with AMI compared to subjects without CAD (7.5 ng/ml vs. 5.4 ng/ml, P < 0.05) or stable CAD (7.5 ng/ml vs. 5.7 ng/ml, P = 0.01). Laminin and CVI were significantly higher in patients with severely reduced left ventricular function. Laminin and CVI values were significantly correlated (r = 0.6). CONCLUSION: Our data suggest that laminin and CVI serum levels can be potential surrogate parameters of ECM remodelling after AMI. We hypothesize that serum laminin reflects early ECM-remodelling involved in the process of postischaemic tissue degradation and repair, and CVI may be a marker of collagen denaturation and shifts in the collagen phenotype ratios.