Friday, May 05, 2006

P1GF and AMI, News from Japan

Heart attack is a frightening complication of CAD, and large infarct areas with loss of myocardial function is a dreaded complication which invariably occurs with heart attacks. Furious research is going on in many universities throughout the world, to try and find a way of growing myocardial sarcomeres in an attempt to promote myocardial function recovery follwoing myocardial infarction.

Researchers in Nara Medical University Japan, led by Najime Iwarma, have just reported in JACC 47:1559-1567, 2006, their clinical study on the response of the heart to insults like AMI (acute myocardial infarction) and coronary angioplasty. They noticed that following a heart attack, and also following angioplasty, the heart releases placental growth factor (P1GF), which seem to coincide with a rise in monocyte count. This increase in P1GF seem to lead to improvement in heart function. Hajime and colleaques studied 55 patients, who had their peripheral blood taken on days 1, 3 and 7 following their heart attacks, for estimation of monocyte count and P1GF levels and compared them with similar healthy controls. They also estimate the P1GF levels in the coronary arteries and coronary sinus of their patients following coronary interventions for their AMI. They noticed that the plasma P1GF peaked at day 3, when compared to controls and that this plasma P1GF levels corelated with the rise in monocyte counts and LV function. Plasma P1GF levels were also significantly higher in the coronary sinus just after coronary intervention, and not in the coronary artery suggesting the local production of P1GF from the myocardial cells in response to the intervention and revascularisation.

These findings are indeed interesting, as it helps us to understand further the response of the heart to insults and how the heart attempts to recover from the injury. The fact that the myocardial cells can produce P1GF, and that P1gf seem to be able to inprove LV function lends much hope to the fact that an open coronary artery is always better, translating to better longterm outcomes. There is obviously the opportunity to do more work on the use of administered P1GF to improve LV function and improve LV remodelling following a heart attack.

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