Objective: Assaying of relation between serum change trait of inflammation and collagen type I turnover mar-kers in early (first 7 days) and late (2nd month) period of post-infarction myocardial remodeling in patients with STEMI after angioplasty and remodeling pattern: adaptive or pathological.
Material and Methods: Using ELISA method serum levels of 26 markers of inflammation (20 pro- and 6 anti-inflammatory) have been determined daily in 148 patients with STEMI during first 7 days after angioplas-ty as well as 2 markers of fibrillar collagen type I turno-ver (PINP and CITP as markers of synthesis and degra-dation, respectively) after 2 months (period of active replacement scaring/fibrosis based on collagen type I). Post-infarction myocardial remodeling patterns, adap-tive (AMR) or pathological (PMR) have been attested using relevant echocardiographic criteria in 5 months after revascularization relied basically on left ventricle end-diastolic volume increase more than 20%.
Results: The PMR was detected in 38.5% of patients, the key sign being enhancement of end diastolic vo-lume index by 22.8±2.7%. Pro-inflammatory marker changes were similar in both patterns of remodeling: their elevation toward 3rd day (period of macropha-ge type 1 activation) followed by a decline from 4th to 7th day averagely till presentation level. Among anti-inflammatory markers the change of IL-4 and IL-10 was in a close relation to remodeling pattern. Thus, in patients who developed AMR the serum levels of IL-4 and IL-10 elevated from 4^th to 7^th day (period of macro-phage type 2 activation) by 52-54% while in PMR these interleukins increased by only 6,5%. CITP serum level assayed after 2 months did not differ in patients with either AMR or PMR: 24.28±2.5 vs. 22.67±2.7 μg/L. However, the PINP changing was conspicuously linked to remodeling pattern: the marker increased by 105.5% (p<0.01) in AMR comparatively to presentation level (37.71±3.9 vs. 18.35±2.1 μg/L) and only a rise of 41.8% (p<0.05) was found in PMR (24.39±2.8 vs. 17.21±2.2 μg/L).
Conclusions: Among markers of inflammation and collagen type I turnover the serum levels of IL-4, IL-10 and PINP might be emphasized as predictors of post-infarction remodeling pattern in patients with STEMI. Elevation of IL-4 and IL-10 more than 50% from 4^th to
Objective: Assaying of relation between serum change trait of inflammation and collagen type I turnover mar-kers in early (first 7 days) and late (2nd month) period of post-infarction myocardial remodeling in patients with STEMI after angioplasty and remodeling pattern: adaptive or pathological.
Material and Methods: Using ELISA method serum levels of 26 markers of inflammation (20 pro- and 6 anti-inflammatory) have been determined daily in 148 patients with STEMI during first 7 days after angioplas-ty as well as 2 markers of fibrillar collagen type I turno-ver (PINP and CITP as markers of synthesis and degra-dation, respectively) after 2 months (period of active replacement scaring/fibrosis based on collagen type I). Post-infarction myocardial remodeling patterns, adap-tive (AMR) or pathological (PMR) have been attested using relevant echocardiographic criteria in 5 months after revascularization relied basically on left ventricle end-diastolic volume increase more than 20%.
Results: The PMR was detected in 38.5% of patients, the key sign being enhancement of end diastolic vo-lume index by 22.8±2.7%. Pro-inflammatory marker changes were similar in both patterns of remodeling: their elevation toward 3rd day (period of macropha-ge type 1 activation) followed by a decline from 4th to 7th day averagely till presentation level. Among anti-inflammatory markers the change of IL-4 and IL-10 was in a close relation to remodeling pattern. Thus, in patients who developed AMR the serum levels of IL-4 and IL-10 elevated from 4^th to 7^th day (period of macro-phage type 2 activation) by 52-54% while in PMR these interleukins increased by only 6,5%. CITP serum level assayed after 2 months did not differ in patients with either AMR or PMR: 24.28±2.5 vs. 22.67±2.7 μg/L. However, the PINP changing was conspicuously linked to remodeling pattern: the marker increased by 105.5% (p<0.01) in AMR comparatively to presentation level (37.71±3.9 vs. 18.35±2.1 μg/L) and only a rise of 41.8% (p<0.05) was found in PMR (24.39±2.8 vs. 17.21±2.2 μg/L).
Conclusions: Among markers of inflammation and collagen type I turnover the serum levels of IL-4, IL-10 and PINP might be emphasized as predictors of post-infarction remodeling pattern in patients with STEMI. Elevation of IL-4 and IL-10 more than 50% from 4^th to 7^th day after revascularization as well as PINP increase more than doubly after 2 months comparatively to pre-sentation level is inherent to adaptive remodeling.