Abstract
ObjectiveThe role of neutrophil extracellular traps (NETs) in acute heart failure is unknown. We recently showed that interleukin 8, a putative NETs stimulator, was associated with myocardial recovery in acute heart failure complicating ST-elevation myocardial infarction (STEMI). In this exploratory post-hoc study, we aimed to investigate the role of NETs components in relation to myocardial function and interleukin 8 in STEMI patients with symptomatic acute heart failure.MethodsIn 61 STEMI patients developing acute heart failure within 48 hours of successful revascularization, wall motion score index (WMSI), global longitudinal strain (GLS) and left ventricular ejection fraction (LVEF) were assessed by echocardiography at baseline and on day 5. Blood drawn at baseline and days 1, 2 and 5 was used to quantify double-stranded DNA (dsDNA), myeloperoxidase-DNA complexes (MPO-DNA) and citrullinated histone 3 (CitH3). The area under the curve (AUC) of each NETs marker and interleukin 8 was approximated for the first 5 days.ResultsdsDNAAUC and MPO-DNAAUC correlated significantly with change in WMSI from baseline to day 5 (rs = 0.28 for both, p≤0.05), whereas NETs AUCs did not correlate with changes in GLS and LVEF. dsDNAAUC was significantly correlated with interleukin 8AUC (r = 0.40, p = 0.003). However, mixed model regression could not identify a significant effect of the NETs components on myocardial function parameters.ConclusionsIn this cohort with acute heart failure complicating STEMI, NETs components were partly correlated with myocardial function and interleukin 8 levels, yet no causal relationship between NETs components and myocardial recovery could be established.Clinical trial registrationClinicalTrials.gov, identifier: NCT00324766.
Highlights
Patient outcomes after ST-elevation myocardial infarction (STEMI) have improved considerably over the last decades, the incidence of heart failure during hospitalization for the index myocardial infarction (MI) is still estimated at nearly 30% [1], necessitating the ongoing search for biomarkers and potential therapeutic targets
Results dsDNAAUC and MPO-DNAAUC correlated significantly with change in wall motion score index (WMSI) from baseline to day 5, whereas neutrophils also release extracellular traps (NETs) area under the curve (AUC) did not correlate with changes in global longitudinal strain (GLS) and left ventricular ejection fraction (LVEF). dsDNAAUC was significantly correlated with interleukin 8AUC (r = 0.40, p = 0.003)
In this cohort with acute heart failure complicating STEMI, NETs components were partly correlated with myocardial function and interleukin 8 levels, yet no causal relationship between NETs components and myocardial recovery could be established
Summary
Patient outcomes after ST-elevation myocardial infarction (STEMI) have improved considerably over the last decades, the incidence of heart failure during hospitalization for the index myocardial infarction (MI) is still estimated at nearly 30% [1], necessitating the ongoing search for biomarkers and potential therapeutic targets. In this pursuit, sustained inflammation has gained attention as a contributor to the development of ischemic heart failure [2,3,4]. The contribution of NETs components with respect to AHF complicating MI has not previously been reported on
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