| Objective To investigate the relationship between nicotinamide adenosinedinucleotide phosphate oxidase(NADPH oxidase) of peripheral blood mononuclear cellsand left ventricular remodeling in patients with myocardial infarction.Methods Seventy-seven hospitalized patients with acute myocardial infarction(AMI) from December2010to August2011were selected as AMI group, and twenty-fourhospitalized patients with paroxysmal supraventricular tachycardia were selected as controlgroup. The height and weight of each patient was measured, body surface area (BSA) andbody mass index (BMI) were calculated. On the second day after admission, fasting bloodwas drawn to measure the level of biochemical markers, malondialdehyde (MDA),superoxide (O2-) and the activity of monocytic NADPH oxidase. All patients receiveddoppler echocardiography to calculate left ventricular end-diastolic volume index(LVEDVi), ejection fraction (EF), and left ventricular mass index(LVMI). All of thesewere measured in the follow-up visits after six months. The level of MDA, O2-andNADPH oxidase activity of each group were compared, the changing trends of the aboveindexes after AMI, and the relationships between the above indexs and left ventricularremodeling were analysed.Results1General clinical data comparisonThe levels of FBG, TC, TG, LDL-C and hsCRP in AMI group were higher than those ofcontrol group at admission, the HDL-C level in AMI group was lower than that of controlgroup, the differences were statistically significant(P<0.05). There was a downward trend of the levels of FBG, TC, TG, LDL-C, UREA, Cr-S and a rising trend of the level ofHDL-C and UA in the follow-up visit after6months comparing with the levels of theabove indexes at admission in47AMI patients, but there were no statistical differences(P>0.05). The level of hsCRP significantly decreased (P<0.01). The levels of FBG, TG,LDL-C and hsCRP in the follow-up AMI patients after6months were higher than these incontrol group, and the level of HDL-C was lower, the differences were statisticallysignificant(P<0.05).2LVEDVi, LVMI and EF comparisonThe values of LVEDVi, LVMI and EF were [(72.16±12.28)ml/m~2] and[(45.96±8.83)ml/m~2],[(111.09±23.45)g/m~2] and [(80.94±16.28)g/m~2],[(51.83±13.64)%]and [(67.08±6.51)%] respectively for AMI group and control group at admission, thedifferences were statistically significant (P<0.01). The values of LVEDVi and LVMI were[(82.06±19.85)ml/m~2] and [(74.13±14.41)ml/m~2],[(123.26±31.98)g/m~2] and[(108.07±24.35)g/m~2] respectively for47AMI patients after6months and at admission,the differences were statistically significant (P<0.01). The values of EF were[(47.57±12.93)%] and [(51.80±12.65)%] respectively for47AMI patients after6monthsand at admission, there was no statistical difference (P>0.05).3MDA concentration comparisonThere was significant difference for the concentration of MDA between AMI group andcontrol group at admission [（6.17±2.76）nmol/ml vs（2.81±1.70）nmol/ml, P<0.01]. TheMDA concentration of47follow-up AMI patients after6months [（3.58±1.26) nmol/ml]was significantly lower than that at admission [（6.11±2.89) nmol/ml](P<0.01), and higherthan that of control group at admission, but the difference was not statistically significant(P>0.05).4O2-concentration comparisonThe concentration of O2-in AMI group was significantly higher than that of controlgroup at admission [(11.20±5.95)RLU/mg protein vs (6.26±2.23)RLU/mg protein, P<0.01].The concentration of O2-in47follow-up AMI patients six months later [（6.86±2.75) RLU/mg protein] was significantly lower than that at admission [（11.95±6.60) RLU/mgprotein](P<0.01), and higher than that of control group at admission, but the differencewas not statistically significant (P>0.05).5NADPH oxidase activity comparisonThe activity of NADPH oxidase was higher in AMI group than control group atadmission [(14.13±4.48)RLU/mg protein vs (7.47±2.62)RLU/mg protein, P<0.01]. Theactivity of NADPH oxidase in47follow-up AMI patients six months later [(8.38±3.76)RLU/mg protein] was significantly lower than that at admission [(14.17±3.88) RLU/mgprotein](P<0.01), and higher than that of control group, but the difference was notstatistically significant (P>0.05).6The relationship between MDA concentration, O2-concentration, NADPH oxidaseactivity and left ventricular remodelingThe MDA concentration of AMI group at admission was positively associated withLVMI (r=0.45, P<0.05), the concentration of O2-had a positive correlation with LVMI(r=0.53, P<0.01), and NADPH oxidase activity also positively correlated with LVMI(r=0.65, P<0.01). After six months in47follow-up AMI patients, the MDA concentrationwas positively associated with LVMI (r=0.32, P<0.05), the concentration of O2-had apositive correlation with LVMI (r=0.55, P<0.05), and NADPH oxidase activity positivelycorrelated with LVMI (r=0.77, P<0.01).Conclusions1. The concentration of MDA and O2-and the activity of monocytic NADPH oxidasein AMI patients were significantly higher than those of control group. This suggests thatthe oxidative stress is involved in the process of AMI.2. The concentrations of MDA and O2-and the activity of monocytic NADPH oxidasein AMI patients receiving conventional treatment for6months were significantly lowerthan these at admission.This indicates that conventional treatment can effectively reducethe oxidative stress level of AMI patients.3. The concentrations of MDA and O2-and the activity of monocytic NADPH oxidase had positive correlations with LVMI respectively, and the NADPH oxidase activity had themost significant positive correlation with LVMI. This suggests that the oxidative stressinduced by the increased activity of NADPH oxidase plays an important role in thedevelopment of left ventricular remodeling after myocardial infarction. |
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