The association of ventricular tachycardia and endothelial dysfunction in the setting of acute myocardial infarction with ST elevation
Vedrana Škerk, Alemka Markotić, Diana Delić Brkljačić, Šime Manola, Tomislav Krčmar, Ivo Darko Gabrić, Gordana Štajminger, Hrvoje Pintarić
Department of Cardiology, Internal Medicine Clinic, Clinical Hospital Centre „Sisters of Charity“, Zagreb, Croatia
Med Sci Monit 2013; 19:1027-1036
Ventricular tachycardia (VT) is frequently seen in ischemic settings like acute myocardial infarction with ST segment elevation (STEMI). Endothelial dysfunction (ED) represents inflammation and the loss of all protective features of the endothelium. We aimed to examine the association between VT and ED in patients with STEMI.
Material and Methods: The study included 90 subjects (30 with VT and acute STEMI, 30 with STEMI without VT, and 30 controls). Sera of all subjects were tested on ED markers by enzyme immunoassay: sICAM-1 (intracellular adhesive molecule-1), sVCAM-1 (vascular adhesive molecule-1), P- and E-selectins, and VEGF (vascular endothelial growth factor). In addition, CRP (C-reactive protein) was detected.
Results: Significantly increased values of low-density lipoprotein, triglycerides, leukocytes, creatinine, and the number of cigarettes smoked were observed among patients with VT+STEMI in comparison to controls. The levels of E-selectin were significantly lower in the VT+STEMI group than in the other groups, while the levels of VCAM-1 were significantly higher in the groups with STEMI and VT+STEMI compared to the controls. Lower levels of VEGF were recorded in STEMI and VT+STEMI groups compared to the control group. A significant correlation between CRP and VCAM-1 in patients with VT +STEMI was demonstrated.
Conclusions: We showed that ED may have a role in the immunopathogenesis of VT in patients with STEMI. The role of sE-selectin and correlation of sVCAM-1 with CRP as possible ED predictive markers in patients with VT+STEMI should be further investigated in a large cohort of patients.
Keywords: C-Reactive Protein - metabolism, Biological Markers - blood, Case-Control Studies, Electrocardiography, Endothelium, Vascular - physiopathology, Immunoenzyme Techniques, Inflammation - physiopathology, Intercellular Adhesion Molecule-1 - blood, Myocardial Infarction - complications, Selectins - blood, Statistics, Nonparametric, Tachycardia, Ventricular - physiopathology, Vascular Cell Adhesion Molecule-1 - blood, Vascular Endothelial Growth Factor A - blood