Correlations Between CTPR-9 And Post-ami Ventricular Remodeling

Objective: The morbidity of AMI is ascending, and increasingly younger in China. With the new antithrombotic and antiplate put into use, as well as the promotion of PCI, the mortality of AMI and adverse cardiovascular events are in decline. In most cases, however, the patient survivals gradually develop heart failure. Left ventricular remodeling(LVRM) is the basically pathogenesis of post-AMI heart dysfunction. It is confirmed that a series of inflammatory reactions involve in the pathogenesis of myocardial infarction, and there is some relevance between them. The treatment of anti-inflammatory can thus inhibit ventricular remodeling, improving cardiac function and prognosis. As a newly family numbers of adipokines, CTRP9 has high homology with adiponectin. An experiment on animals shows that CTRP9 eases the ventricular remodeling of post-AMI, but it remains to be confirmed by clinical research. The aim of this study, in general, is therefore to investigate the change of serum CTRP9 levels in AMI patients and the correlations between CTRP9 and LVESV, EF, LVEDV, and assess the value of CTRP9 in post-AMI ventricular remodeling.Methods: This study consisted of 126 patients(men69 and women57; mean age, 61.22±9.01years) with first ST-segment elevation myocardial infarction who were admitted within 12 hours in the Second Hospital of Hebei Medical University from January 2014 to January 2015.All the patients accord acute myocardial infarction Guideline of China. Patients with previous MI, rheumatic heart disease, thyroid disease, tuberculosis, malignancy, acute infection were excluded. All blood samples of the patients were drawn on 72 hours after onset to measure the levels of CTRP9 by means of ELISA. After two weeks echocardiogram was performed. The data obtained left ventricular ejection fraction(LVEF) and left ventricular end-diastolic and end-systolic volumes(LVEDV, LVESV). All patients were given routine medicine and some received emergency PCI or thrombolysis. The history of disease, serum lipid, fasting plasma glucose and so on was recorded in detail. Sixty healthy persons(32 men and 28 women; mean age, 60.7±10.71 years) were chosen as normal control group. All the AMI patients were divided into two groups by the Median of CTRP9: low CTRP9 group and high CTRP9 group. The data were basically analyzed by SPSS 21.0 software. Numeric variables were expressed as mean±SD. A value P<0.05 was considered statistically significant.Results:The serum CTRP9 level of the control group was and AMI group was 137.90±37.22ng/ml and 56.64±38.06ng/ml. A great discrepancy could be noted. All the patients with AMI into two groups by the Median of CTRP9 45.07ng/ml: low CTRP9 group(CTRP9<45.07ng/ml)and high CTRP9 group(CTRP9>45.07ng/ml). The low CTRP9 group contained 63patients: 34 male and 29 female, mean age 61.30±8.67(46~77) years. The high CTRP9 group contained 63 patients: 35 male and 28 female, mean age 61.15±9.57(46~77) years. There was no significant difference between the age, sex, DM, hypertension, serum lipid, fasting plasma glucose,treatment of the two groups(P>0.05). The data of echocardiogram in low CTRP9 group were: LVEF 42.26±6.31%, LVED V149.14±7.01 ml, LVESV 76.41±7.05ml; he high CTRP9 group results were: LVEF 50.75±5.90%, LVEDV 129.30± 9.86 ml, LVESV 58.86±6.71 ml. All these parameters between two groups had remarkable differences(P<0.01). There were considerably positive corr- elations between CTRP9 and LVEDV, LVESV. The correlation coefficients were respectively-0.887,-0.873(P<0.01). CTRP9 correlated negatively with LVEF(r=0.770, P<0.01). Spearman correlation revealed that CTRP9 had positive correlation with LVRM(r=-0.569, P<0.01).Conclusion:With the decrease of CTRP9, the EF of the patient declined, and LVEDV, LVESV were expanded. The study thus demonstrates that CTRP9 can generally assess the post-AMI ventricular remodeling.