Correlation Between Inflammatory Response And Cardiac Function After Left And Right Coronary Reperfusion In Patients With Acute Myocardial Infarction

Objective:Left and right coronary artery obstruction and reperfusion have different prognosis for myocardial infarction patients.The purpose of this study was to analyze the correlation between inflammatory response and myocardial function within 1 week after left and right coronary ischemia-reperfusion,to explore the differences between the two groups,and to provide experimental evidence for myocardial protection and prevention of heart failure.Methods:1.The clinical data of 384 patients with acute myocardial infarction admitted to hospital from 2016 to 2018 who underwent PCI during the emergency treatment time window were analyzed.The t-test was used to analyze the left and right coronary lesions(L,R).White blood cell count,neutrophil count,lymphocyte count,monocyte count,ratio of neutrophil to lymphocyte counts(NLR).Pearson’s correlation statistical analysis of neutrophil count,monocyte count,NLR and myocardial injury index(CK,CK-MB)or cardiac function(left ventricular ejection fraction,LVEF and fractional shortening,FS)relationship were conducted.2.Cultured rat cardiomyocytes(H9C2)were treated with IL-6 1.38uM,100uL,right and left coronary lesion patients’ venous and arterial serum 100 ul,respectively.The expression of iNOS protein was detected by western blotting and the difference in protein expression between the groups was observed.3.Blood samples from left and right coronary artery lesion patients were collected and they were grouped as L and R.Inflammatory cytokines were analyzed through Elisa.4.The serum samples of 13 cases in group L and 12 cases in group R were collected,and Human Cytokine Array test was conducted(Ray Biotech)to detect the differences in inflammatory factors between two groups.Results:1.The clinical data of 384 patients with acute myocardial infarction showed that the mean leukocytes,neutrophils,monocytes,CK,CK-MB,EF and FS were not different between L and R groups(P>0.05).2.Overall,data showed that white blood cell count,neutrophil count and NLR were significantly correlated with myocardial injury index(CK,CK-MB)after ischemia-reperfusion(p<0.001),but no correlation was observed with cardiac function indicators(EF,FS)(p>0.05).2.In group L,neutrophil count,NLR or monocyte count were positively correlated with myocardial injury index(CK,CK-MB)(p<0.001,p<0.001 and p<0.05,respectively);neutrophil count was negatively correlated with EF(p<0.05);In the R group,neutrophil count was positively correlated with CK and CK-MB(p<0.05);monocyte count or NLR was not associated with CK、CK-MB、EF or FS(p>0.05).3.The expression of iNOS protein was increased in IL-6,Rv,Ra,Lv and La groups compared with that of control group(p<0.05).There was no difference between L and R groups.4.The concentration of IL-10 and TGF-β in the L group was higher than that in the R group by Elisa method,but the difference was not statistically significant(p>0.05).5.Human Cytokine Array results showed that out of 40 cytokines,the expressions of IL-17,I-309,MIG,MIP-1d group L were significantly increased compared with group R(p<0.05).Conclusion:Results from 384 patients with acute myocardial infarction one week after surgery showed that the indicators of inflammation(white blood cell count,neutrophil count,monocyte count,NLR)were not significantly different between the left and right coronary groups.The intensity of inflammatory response in the body is related to the degree of myocardial damage,however,the left myocardial infarction is more obvious than the right side.That is,higher NLR is associated with severe myocardial damage and left ventricular dysfunction.Moreover,the markers of inflammation in the blood of patients with left myocardial infarction are significantly different from the right side.The role of these factors in myocardial function and its mechanisms should be explored further.