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Angiotensin II AT 1 receptor density on blood platelets predicts early left ventricular remodelling in non‐reperfused acute myocardial infarction in humans
Author(s) -
Maczewski Michal,
Borys Marcin,
Kacprzak Pawel,
Gdowski Tomasz,
Wojciechowski Dariusz
Publication year - 2006
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/j.ejheart.2005.06.009
Subject(s) - medicine , cardiology , myocardial infarction , ejection fraction , ventricular remodeling , heart failure , angiotensin ii , infarction , receptor
Background: Renin—angiotensin‐system activity, a principal factor determining ventricular remodelling after myocardial infarction (MI), is dependant on local angiotensin II concentration and angiotensin AT 1 receptor (AT 1 R) density. The latter is regulated by systemic factors acting independently from angiotensin II concentration. Objective: To test the hypothesis that AT 1 R density at the onset of MI determines post‐MI ventricular remodelling. Methods: In 48 patients with first acute MI who did not undergo reperfusion therapy, angiotensin AT 1 R density on blood platelets (reflecting cardiovascular AT 1 R density) was assessed 13±5 h after the onset of MI, using radioligand binding assay. Left ventricular end‐systolic (LVESVI) and end‐diastolic volume indices (LVEDVI) and ejection fraction (EF) were assessed by two‐dimensional echocardiography as measures of ventricular remodelling. Results: Predischarge LVESVI and LVEDVI positively and EF negatively correlated with AT 1 R density. Patients with AT 1 R density below median had significantly lower LVESVI (33.2±2.4 mL/m 2 ), LVEDVI (70.0±2.8 mL/m 2 ) and higher EF (52.8±2.3%) than patients with AT 1 R density above median (LVESVI=44.9±2.6, LVEDVI=81.3±3.9 mL/m 2 and EF=44.9±2.6%, all p <0.01). In multivariate analysis, only AT 1 R density and infarct size were independent predictors of early post‐MI ventricular dilation. Conclusions: High density of AT 1 R at the onset of MI is a predictor of early left ventricular remodelling.