Key result
Ventricular tachycardia in STEMI was associated with significantly lower E-selectin and higher VCAM-1 levels compared to controls, suggesting a role for endothelial dysfunction.
Why the study?
Are endothelial dysfunction markers associated with ventricular tachycardia in patients with acute STEMI?
Case-Control (n=90)
Are endothelial dysfunction markers associated with ventricular tachycardia in patients with acute STEMI?
Endothelial dysfunction markers, specifically E-selectin and VCAM-1, are altered in patients with STEMI and ventricular tachycardia, suggesting a potential role in its immunopathogenesis.
Answers are grounded in this paper and cite their sources.
Hypothesis-generating link between endothelial markers and ventricular tachycardia in STEMI; prospective studies needed before any clinical application.
BACKGROUND: 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/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.
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Hrvoje Pintarić (2013) conducted a case-control in Acute myocardial infarction with ST elevation (STEMI) and Ventricular tachycardia (VT) (n=90). Ventricular tachycardia in the setting of STEMI vs. STEMI without VT and controls was evaluated on Endothelial dysfunction markers (sICAM-1, sVCAM-1, P- and E-selectins, VEGF, CRP). Ventricular tachycardia in STEMI was associated with significantly lower E-selectin and higher VCAM-1 levels compared to controls, suggesting a role for endothelial dysfunction.
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