Autonomic dysfunction is associated with high mobility group box-1 levels in patients after acute myocardial infarction

作者：Giallauria Francesco^*; Cirillo Plinio; Lucci Rosa; Pacileo Mario; D'Agostino Mariantonietta; Maietta Paola; Vitelli Alessandra; Chiariello Massimo; Vigorito Carlo

来源：Atherosclerosis, 2010, 208(1): 280-284.

DOI：10.1016/j.atherosclerosis.2009.07.025

• High mobility group box-1
• Autonomic dysfunction
• Heart rate recovery
• Cardiac remodeling
• Myocardial infarction
• Left ventricular remodeling

Background: High mobility group box-1 (HMGB1) protein, a critical mediator of inflammatory processes, is a novel predictor of adverse post-infarction clinical outcomes, being involved in the healing process after MI. Heart rate recovery (HRR), a marker of autonomic function defined as the fall in heart rate during the first minute after exercise, is a powerful predictor of mortality in post-infarction patients. The present study was designed to test the hypothesis that HMGB1 is associated with autonomic dysfunction in post-infarction patients.
Methods: Sixty-seven consecutive patients ( mean age 59.3 years, 84% males) recovering from acute MI were included in the study protocol. All patients underwent Doppler-echocardiography, cardiopulmonary exercise and HMGB1 assay.
Results: HMGB1 levels were inversely correlated with peak oxygen consumption (VO(2peak)) (r = -0.449, P < 0.001), with left ventricular ejection fraction (LVEF) (r = -0.360, P = 0.003), and with HRR (r = -0.387, P < 0.001). In a linear regression analysis adjusted for multiple confounders, we found a significant inverse association between HMGB1 levels and HRR independent of age, gender, body mass index, VO(2peak), slope of increase in ventilation over carbon dioxide output (VE/VCO(2slope)), and presence of diabetes (beta = -0.377, P = 0.034).
Conclusions: This study provided the first evidence for a significant association between increased HMGB1 levels and autonomic dysfunction expressed by post-exercise slower HRR in post-infarction patients. The prognostic implication of such association needs to be explored as well as whether HMGB1 could represent a valid marker for risk stratification either during the acute phase or long-term after MI.

• 出版日期2010-1