Expression of vascular endothelial growth factor in patients with acute myocardial infarction

OBJECTIVE The purpose of this study was to investigate the clinical signifi cance of vascular endothelial growth factor (VEGF) in acute myocardial infa rction (AMI). We also examined the involvement of peripheral blood mononucl ear cells (PBMCs), which are a possible source of VEGF in AMI. BACKGROUND VEGF is a potent endothelial cell-specific mitogen and could aff ect the outcome of AMI. METHODS Thirty patients with AMI were used for this study. Serum and PBMCs were isolated from peripheral blood on days 1, 7, 14 and 21 after the onset of AMI. PBMCs were cultured at a density of 5 x 10(6) cells/ml for 24 h. V EGF levels in serum and the culture media were measured by enzyme-linked im munosorbent assay using a specific anti-human VEGF antibody. RESULTS Serum VEGF levels elevated gradually after the onset of AMI and rea ched a peak on day 14. VEGF levels in the culture medium of PBMCs after inc ubation for 24 h (PBMC-VEGF) were maximally elevated 7 days after the onset , Maximum serum VEGF levels showed significant positive correlations with m aximum creatine phosphokinase (CPK) levels (r = +0.70, p < 0.001), but maxi mum PBMC-VEGF levels did not correlate with maximum CPK levels. Patients sh owing improvement in left ventricular systolic function during the course o f AMI showed significantly higher PBMC-VEGF levels than patients without im provement. CONCLUSIONS The extent of myocardial damage contributes to the elevation of serum VEGF levels in AMI. VEGF produced by PBMCs may play an important rol e in the improvement of left ventricular function by promoting angiogenesis and reendothelialization after AMI. (C) 2000 by the American College of Ca rdiology.