CD 14++ CD 16+ monocytes in patients with acute ischaemic heart failure

Background Monocytes play important roles in inflammation, angiogenesis and tissue repair and may contribute to the pathophysiology of heart failure ( HF ). Objectives We examined differences in monocyte subset numbers and expression of cell surface markers of activation ( CD 14) and chemotaxis ( CCR 2) in patients with acute HF ( AHF ), stable HF ( SHF ), and controls and evaluated their impact on clinical outcomes. Methods Three monocyte subsets [ CD 14++ CD 16−CCR2+ ( M on1), CD 14++ CD 16+ CCR 2+ ( M on2) and CD 14+ CD 16++ CCR 2− (Mon3)] were analysed by flow cytometry in 51 patients with AHF , 42 patients with SHF , 44 patients with stable coronary artery disease and without HF ( CAD ) and 40 healthy controls ( HC ). The prognostic impact of monocyte subsets was examined in AHF . Results Patients with AHF had significantly higher M on1 counts compared to the three control groups ( P  < 0·001 for all). Similarly, M on2 levels were increased in AHF compared to SHF ( P  = 0·004) and CAD ( P  < 0·001) and increased in SHF vs. CAD ( P  = 0·009). There were no differences in M on3 counts between the groups. Twenty patients (39·2%) with AHF reached the primary end‐point of death or re‐hospitalisation, and after adjustment for confounders, M on2 count remained negatively associated with a combined end‐point of death and re‐hospitalisation [hazard ratio (per 10 cells/μL): 0·79; confidence interval: 0·66–0·94; P  = 0·009]. Conclusions Mon2 counts are increased in patients with both acute and stable HF , with enhanced expression of surface markers of activation ( CD 14) and chemotaxis ( CCR 2). This subset was also associated with an adverse prognosis in patients with AHF .