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CLINICAL STUDIES

Expression of vascular endothelial growth factor in patients with acute myocardial infarction

^a Department of Cardiology, Jichi Medical School, Minamikawachi-machi, Tochigi, Japan

Manuscript received February 5, 1999; revised manuscript received October 15, 1999, accepted November 22, 1999.

Reprint requests and correspondence: Dr. Uichi Ikeda, Department of Cardiology, Jichi Medical School, Minamikawachi-machi, Tochigi 329-0498, Japan
uikeda{at}jichi.ac.jp

OBJECTIVE

The purpose of this study was to investigate the clinical significance of vascular endothelial growth factor (VEGF) in acute myocardial infarction (AMI). We also examined the involvement of peripheral blood mononuclear cells (PBMCs), which are a possible source of VEGF in AMI.

BACKGROUND

VEGF is a potent endothelial cell–specific mitogen and could affect the outcome of AMI.

METHODS

Thirty patients with AMI were used for this study. Serum and PBMCs were isolated from peripheral blood on days 1, 7, 14 and 21 after the onset of AMI. PBMCs were cultured at a density of 5 x 10⁶ cells/ml for 24 h. VEGF levels in serum and the culture media were measured by enzyme-linked immunosorbent assay using a specific anti-human VEGF antibody.

RESULTS

Serum VEGF levels elevated gradually after the onset of AMI and reached a peak on day 14. VEGF levels in the culture medium of PBMCs after incubation for 24 h (PBMC-VEGF) were maximally elevated 7 days after the onset. Maximum serum VEGF levels showed significant positive correlations with maximum creatine phosphokinase (CPK) levels (r = +0.70, p < 0.001), but maximum PBMC-VEGF levels did not correlate with maximum CPK levels. Patients showing improvement in left ventricular systolic function during the course of AMI showed significantly higher PBMC-VEGF levels than patients without improvement.

CONCLUSIONS

The extent of myocardial damage contributes to the elevation of serum VEGF levels in AMI. VEGF produced by PBMCs may play an important role in the improvement of left ventricular function by promoting angiogenesis and reendothelialization after AMI.

Abbreviations and Acronyms   AMI = acute myocardial infarction   CAG = coronary angiography   CPK = creatine phosphokinase   ELISA = enzyme-linked immunosorbent assay   LVEF = left ventricular ejection fraction   LVG = left ventriculography   PBMCs = peripheral blood mononuclear cells   PTCA = percutaneous transluminal coronary angioplasty   VEGF = vascular endothelial growth factor   VSMCs = vascular smooth muscle cells

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