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अमूर्त

Relationship between Fibroblast Growth Factor 21 and Extent of Left Ventricular Remodeling after Acute Myocardial Infarction

Hideyuki Kondo, Yukihiro Hojo, Toshinobu Saito, Tomokazu Ikemoto, Takaaki Katsuki, Kazuyuki Shimada and Kazuomi Kario

Background: Fibroblast growth factor 21 (FGF21) is a novel myokine released from skeletal muscle. Recent studies have showed that FGF21-transgenic mice had low plasma levels of insulin-like growth factor-1, a potent tissue survival factor, in ischemic myocardium following acute myocardial infarction (AMI).

Objective: To examine a role of FGF21 in subsequent complication after AMI.

Methods: Patients experiencing their first AMI (n=71, mean age 62.4±10.1 years old) was employed. Successful coronary reperfusion was accomplished within 12 hours in all patients. Plasma FGF21 levels were measured on admission, and 7 days and 6 months after onset. Left ventricular (LV) remodeling was assessed by left ventriculography on the day of admission and 6 months after AMI.

Results: Levels of FGF21 in plasma peaked on admission and had declined by 6 months (admission: 611±40, day 7: 246±23, 6 months: 316±24 pg/ml, P<0.001). The FGF21 levels were correlated with plasma lactate levels on admission (r=+0.26, P=0.03). The LV end-diastolic volume index (LVEDVI) significantly increased 6 months after AMI (admission: 79.5±2.4, 6 months: 84.5±2.9 ml/m 2 , P=0.004). The FGF 21 levels on admission were positively correlated with the changes in LVEDVI (r=+0.23, P=0.04). The multivariate regression analysis showed that the plasma FGF21 levels on admission was a significant explanatory variable for the changes in LVEDVI (β=+0.232, P=0.041).

Conclusions: These results suggest that a novel myokine, FGF21, reflects circulatory insufficiency and could be a marker for late-stage LV remodeling after AMI.