Background and Aims: Surface expression of&nbsp; platelet markers enhanced during ischemic events and appear to play an important role in myocardial repair. Stromal cell-derived factor-1 (SDF-1) is one of these factors which its effects Mediated through CXCR4 and CXCR7 receptors. In our study we are going to determine the the surface expressions of platelet markers &nbsp;and the changes of left ventricle ejection fraction in patients with coronary artery disease.
Materials and Methods: This descriptive cross-sectional study measured the superficial expression of platelet indices (SDF-1R, CXCR4, and CXCR7) and its association with the changes of the left ventricle ejection fraction in patients with coronary artery disease who have referred to Taleghani Hospital, Tehran in 2016-2018.
Results: Among all patients referred to Taleghani Hospital with symptoms of coronary artery disease, 57 patient had inclusion criteria. this study demonstrated that mean SDF1 and CXCR4 level were respectively 1.1 and 2.3 which there&nbsp; were significant difference between those with severe EF reduction comparing to the rest of the groups (respectively P&lt;0.002 &amp; P&lt;0.004 ). The mean CXCR7 value of all patients was 3.5 (SD= 0.27) and showed a significant difference in patients with severe (6) and low (4.7) ejection fraction reductions compared to those with moderate (2.5) and normal (2.8) ejection fraction reductions (P&lt;0.009).
&nbsp

Ghanbari, Fateme

Gheydari, Mohammad Esmail

Gordan, Hesamaddin

Karvandi, Mersedeh

English

Journals Portal, Shahid Beheshti University of Medical Sciences

2 • School of Medicine Students‘ Journal (2021) 3:2The evaluation of of surface expression of platelet markers and left ventricle ejection fraction in patients with coronary artery diseaseFateme Ghanbari1, Hesamaddin Gordan2 , Mohammad Esmail Gheydari3, Mersedeh Karvandi41- Cardiologist, Tehran, Iran.2- Assistant Professor of Cardiology; Department of Cardiology, Sabzevar University of Medical Sciences, Khorasan Razavi, Iran.3- Assistant  Professor of  Cardiology; Department of Cardiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.4- Associate professor of Cariology, Fellowship in Echocardiographyy; Department of Cardiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.Background and Aims: Surface expression of  platelet markers enhanced during ischemic events and appear to play an important role in myocardial repair. Stromal cell-derived factor-1 (SDF-1) is one of these factors which its effects Mediated through CXCR4 and CXCR7 receptors. In our study we are going to determine the surface expressions of platelet markers  and the changes of left ventricle ejection fraction in patients with coronary artery disease.Materials and Methods: This descriptive cross-sectional study measured the superfi-cial expression of platelet indices (SDF-1R, CXCR4, and CXCR7) and its association with the changes of the left ventricle ejection fraction in patients with coronary artery disease who have referred to Taleghani Hospital, Tehran in 2017-2018. Results: Among all patients referred to Taleghani Hospital with symptoms of coronary artery disease, 57 patient had inclusion criteria. this study demonstrated that mean SDF1 and CXCR4 level were respectively 1.1 and 2.3 which there  were significant difference between those with severe EF reduction comparing to the rest of the groups (respectively P<0.002 & P<0.004 ). The mean CXCR7 value of all patients was 3.5 (SD= 0.27) and showed a significant difference in patients with severe (6) and low (4.7) ejection fraction reductions compared to those with moderate (2.5) and normal (2.8) ejection fraction reductions (P<0.009). Conclusion: Results from this study suggest that the level of surface expression of platelet markers (SDF-1, CXCR4, CXCR7) in patients with coronary artery disease who had severe LV dysfunction rise sharply compared to those with normal ejection fraction, and it can be, therefore, used as a factor to evaluate the level of damage caused by the coronary artery disease.ABSTRACTCorresponding AuthorHesamaddin GordanAssistant Professor of Cardiology, Sabze-var University of Medical sciences, Sab-zevar, Iran.Address: Department of Cardiology , Sabzevar University of Medical sciences, Sabzevar Khorasan Razavi Province, Iran. Postal code: 1333635445Tel: +98 51 44011665 Fax: +98 51 44238719Email: hesamaddingordan@gmail.comorcid.org/0000-0003-3994-3973INTRODUCTIONThis descriptive cross-sectional study measured the su-perficial expression of platelet indices (SDF–1R, CXCR4, CXCR7) and the left ventricle EF changes in patients with coronary heart disease who were referred to Taleghani Hos-pital  during the years 2017-2018. Patients aged 18-60 years of age, who have referred to the hospital with symptoms of coronary heart disease and were admitted for angiography were included. The exclusion criteria were any history of revascularization, cancer and chemotherapy, platelet dis-orders and acute and chronic bleeding, and the consump-tion of medications with hematologic complication. Those who with history of receiving blood and platelet products during the last three months also were excluded as well. The consent forms were taken from the patients in case of a willingness to participate in this study. We get our ethi-cal approval from shahid Beheshti University of medical sciences ethical center with ethical code 1398,12 .To mea-sure the precise function of left ventricle and EF changes, Echocardiography were used after the angiography. In this Article InfoDate Submitted: 8 December, 2020Request Revisions: 2 January, 2021Revised ver. submitted: 10 March, 2021Date Accepted: 17 April, 2021KeywordsPlatelet markers, Ejection fraction, Coro-nary artery diseasehttps://doi.org/10.22037/smsj.v3i2.30452Original ArticleSMSJournal.netCite This Paper as Ghanbari H, Gordan H, Gheydari ME and Karvandi M.The evaluation of of surface expression of platelet markers and left ventricle ejection fraction in patients with coronary artery disease. Sch Med Stud J.2021;3(2):2-5Copyright: © The Author(s) 2021. Open Access This article is distributed under the terms of the Creative Commons Attribution-Noncommercial 4.0 International License (http://creative-commons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source and is not used for commercial purposes.School of Medicine Students‘ Journal (2021) 3:2 • 3cant. Also, a post hoc analysis (in our study, Scheffe post hoc test) was used in order to investigate the association between subgroups. In this study, participants’ information remained confidential, and participation was not compul-sory. Written consent was taken from all participants, and the ethical regulations were based on the provision of the Helsinki convention and acquiesced from the ethical com-mittee.RESULTSA total of 57 patients who have referred to Taleghani Hos-pital with coronary artery disease symptoms were included in this study. All participants underwent echocardiography; 33 patients were in normal group and 10 patients have mild LV systolic dysfunction , 7 patients were diagnosed with moderate LV systolic dysfunction, and 7 patients were cat-egorized as having severe LV function reduction. Table 1 presents the mean values of SDF-1R, CXCR4, and CXCR7 in the groups. The mean SDF-1R value in all pa-tients was 1.11, and there was only a significant difference in patients with severe EF reduction comparing to the rest of the people (p < 0.002).The mean level of CXCR4 in all patients was 2.3, which showed only a significant difference between patients with severe reduction in ejection fraction (3.2) compared to oth-er groups (moderate LV systolic dysfunction (2.1) and Mild Dysfunction (2.3) and patients with  normal LV Function (2/2)) (P = 0.004).The mean measure of CXCR7 among all patients was 3.5, and it had significant differences in groups of severe (6) and low (4.7) EF reductions compared to patients with moderate LV systolic dysfunction (2.5) and normal LV fuc-tion (2.8) EF reductions (P<0.009), as illustrated in table 1.regard, the EF > 55% was an indicator of normal function, EF 40-50% was a sign of mild LV  dysfunction, EF 30-40% showed a modeate Lv dysfunction, and EF <30% suggested a severe reduction of left ventricle function [11].The blood platelet indices count (SDF – 1R, CXCR4, CXCR7) was estimated by a 10 cc fasting blood sample that was taken from all patients, and the level of SDF – 1R, CXCR4, and CXCR7 factors was measured by flow cytom-etry analysis. The collected data were analyzed by SPSS version 25, and the normality of the data was assessed by the Kolmogor-ov-Smirnov test. Normal distribution of the data for the ECG-based comparison of platelet factor, the AVONA test was used, and values below 0.05 were considered signifi-cant. Also, a post hoc analysis (in our study, Scheffe post hoc test) was used in order to investigate the association between subgroups. In this study, participants’ information remained confidential, and participation was not compul-sory. Written consent was taken from all participants, and the ethical regulations were based on the provision of the Helsinki convention and acquiesced from the ethical com-mittee.MATERIALS and METHODSThis descriptive cross-sectional study measured the super-ficial expression of platelet indices (SDF – 1R, CXCR4, CXCR7) and the left ventricle EF changes in patients with coronary heart disease who were referred to Taleghani Hos-pital  during the years 2017-2018.. Patients aged 18-60 years of age, who have referred to the hospital with symp-toms of coronary heart disease and were admitted for angi-ography were included. The exclusion criteria were any his-tory of revascularization, cancer and chemotherapy, platelet disorders and acute and chronic bleeding, and the consump-tion of medications with hematologic complication. Those who with history of receiving blood and platelet products during the last three months also were excluded as well. The consent forms were taken from the patients in case of a willingness to participate in this study. We get our ethi-cal approval from shahid Beheshti University of medical sciences ethical center with ethical code 1398,12 .To mea-sure the precise function of left ventricle and EF changes, Echocardiography were used after the angiography. In this regard, the EF > 55% was an indicator of normal function, EF 40-50% was a sign of mild LV  dysfunction, EF 30-40% showed a modeate Lv dysfunction, and EF <30% suggested a severe reduction of left ventricle function [11].The blood platelet indices count (SDF – 1R, CXCR4, CXCR7) was estimated by a 10 cc fasting blood sample that was taken from all patients, and the level of SDF – 1R, CXCR4, and CXCR7 factors was measured by flow cytom-etry analysis. The collected data were analyzed by SPSS version 25, and the normality of the data was assessed by the Kolmogor-ov-Smirnov test. Normal distribution of the data for the ECG-based comparison of platelet factor, the AVONA test was used, and values below 0.05 were considered signifi-Platelet Markers and LVEF in CADTable 1. Patients’ distribution based on the platelet indices count and EF reduction (LV= Left ventricle, SD= Standard deviation)Platelet Marker LV systolic function Mean SDSDF1Normal 1.07 0.24Mild Dysfunction 1.00 0.22Moderate Dysfunction 1.07 0.08Sever Dysfunction 1.5 0.51Total 1.11 0.3CXCR4Normal 2.21 0.47Mild Dysfunction 2.29 0.7Moderate Dysfunction 2.14 0.55Sever Dysfunction 3.16 1.06Total 2.33 0.68CXCR7Normal 2.85 0.13Mild Dysfunction 4.68 0.44Moderate Dysfunction 2.49 0.05Sever Dysfunction 6.04 0.38Total 3.52 0.274 • School of Medicine Students‘ Journal (2021) 3:2DISCUSSIONThis study suggest that the surface expressions of platelet markers (SDF-1, CXCR4, CXCR7) was increased in pa-tients with coronary artery disease and severe left ventri-cle dysfunction compared to patients with normal EF and, therefore, can be used as an indicator to evaluate the level of damage caused by the coronary artery disease.The expression of stromal cell-derived factor-1 (SDF-1) on the outer surface of platelets in ischemia plays an essential role in the myocardial damage recovery, leading to the mi-gration of progenitor cells from the bone marrow to the site of injury. The CXCR4 and CXCR7 factors mediate the ef-fect of SDF-1 and increase after injury or severe ischemia. Our results were in agreement with the 2017 study of Kiani and colleagues [12], who have suggested that any damages to the heart tissue lead to the inflammatory chemical secre-tion of SDF – 1, and subsequently, the increase of CXCR7 and CXCR4 expression in blood cells. In another study by Mayorga and colleagues in 2018 [13], the mesenchy-mal stem cells (MSC) isolated from the green fluorescent proteins (GFP) were induced to increase the expression of SDF-1 expression. In this study, the administration of MSC significantly improved the EF in control and diabetic rats 21 days after acute myocardial infarction, an outcome that was in line with our findings.Based on a 2014 study by Rath and colleagues, the clini-cal potential of the CXCR7 platelet expression level is an influential factor in mediating the beneficial role of SDF-1 on improving performance in patients with acute coronary disease. Surprisingly, in our study the rate of CXCR7 in the group with mild LV systolic dysfunction was more than that of patients with moderate left ventricle dysfunction, which can be partly explained by the small study population in our study; therefore, inadequate power for statistical anal-yses. However, Schiller and colleagues [14] have neither reported a significant correlation with platelet expression level of CXCR4 and CXCR7 after assessing serum SDF-1 levels among 160 patients with coronary heart disease, as a result, further investigation of this factor will be recom-mended in future studies. Another limitation of our study is to conduct this study with small sample size from a single health center; therefore, broader multi-central studies with larger sample sizes might be required for the adaptation of the results to the general population.CONCLUSIONIn conclusion, based on the results of this study, it can be said that the level of surface expression of platelet markers (SDF-1, CXCR4, CXCR7) in patients with coronary artery disease who had severe left ventricle ejection fraction re-duction rise sharply compared to those with normal ejection fraction, therefore, these platelet markers can be used as an index for the assessment of myocardial damage and left ventricular severe EF reduction.CONFLICT OF INTERESTSAuthors declare that they have no conflict of interest.FUNDINGWe don’t have any financial support and contracts .also we don’t get any funds and Grants from any institutions.REFRENCES1. Corash L, Tan H, Gralnick HR. Heterogeneity of human whole blood platelet subpopulations. Relationship between buoyant density, cell volume, and ultrastructure. Blood. 1977;49(1):71-87.  2. Yamaguchi J, Kusano KF, Masuo O, Kawamoto A, Silver M, Murasawa S, Bosch-Marce M, Masuda H, LosordoDW, Isner JM, Asahara T. Stromal cell-derived factor-1 effects on ex vivo expanded endothelial progenitor cell recruitment for ischemic neovascularization. Circulation 2003; 107:1322–1328.   3. Geisler T, Fekecs L, Wurster T, Chiribiri A, Schuster A, Nagel E, Miller S, Gawaz M, Stellos K, Bigalke B. As-sociation of platelet-SDF-1 with hemodynamic function and infarct size using cardiac MR in patients with AMI. Eur J Radiol 2012;81:e486–e490. 4.  Zhang D, Fan GC, zhou X, Zhao T, Pasha Z, Xu M, Zhu Y, Ashraf M,Wang Y. Overexpression ofCXCR4 on mesen-chymal stem cells augments myoangiogenesis in the infarct-ed myocardium. J Mol Cell Cardiol 2008;44:281–292. 5.  Hu X, Dai S, Wu WJ, TanW, Zhu X, Mu J, Guo Y, Bolli R, Rokosh G. Stromal cell derived factor-1 alpha confers pro-tection against myocardial ischemia/reperfusion injury: role of the cardiac stromal cell derived factor-1 alpha CXCR4 axis. Circulation 2007;116:654–663.6.   Lazarini F, Casanova P, Tham TN, De Clercq E, Arenza-na-Seisdedos F, Baleux F, Dubois-Dalcq M. Differential sig-nalling of the chemokine receptor cxcr4 by stromal cell-de-rived factor 1 and the hiv glycoprotein in rat neurons and astrocytes. Eur J Neurosci 2000;12:117–125.7.  Wegner SA, Ehrenberg PK, Chang G, Dayhoff DE, Sleek-er AL, MichaelNL.Genomic organization and functional characterization of the chemokine receptor cxcr4, a major entry coreceptor for human immunodeficiency virus type 1. J Biol Chem  1998;273:4754–4760. 8. Sierro F, Biben C, Martı´nez-Mun˜oz L, Mellado M, Ran-sohoff RM, Li M, Woehl B, Leung H, Groom J, Batten M. Disrupted cardiac development but normal hematopoiesis in mice deficient in the second CXCL12/SDF-1 receptor, CXCR7. Proc Natl Acad Sci USA 2007;104:14759–14764.9. Burns JM, Summers BC, Wang Y, Melikian A, Berahovich R, Miao Z, Penfold ME, Sunshine MJ, Littman DR, Kuo CJ, Wei K, McMaster BE, Wright K, Howard MC, Schall TJ. A novel chemokine receptor for sdf-1 and i-tac involved in cell survival, cell adhesion, and tumor development. J Exp Med 2006;203:2201–2213 10.  Martinez A, Kapas S, Miller MJ,Ward Y, Cuttitta F. Coexpression of receptors for adrenomedullin, calcitonin gene-related peptide, and amylin in pancreatic beta-cells. Endocrinology 2000;141:406–411.11.   Lang RM, Badano LP, Mor-Avi Victor, et al. Recom-Fateme Ghanbari et al.School of Medicine Students‘ Journal (2021) 3:2 • 5mendations for cardiac chamber quantification by echocar-diography in adults: an update from the American Society of Echocardiography and the European Association of Car-diovascular Imaging. J Am Soc Echocardiogr 2015;28:1. 12.  Kiani AA, Babaei F, Sedighi M, Soleimani A, Ahmadi K, Shahrokhi S, et al. CXCR4 expression is associated with time–course permanent and temporary myocardial infarc-tion in rats. Iran J Basic Med Sci. 2017 Jun; 20(6): 648–654.  13. Mayorga ME, Kiedrowski M, McCallinhart P, Forudi F, Ockunzzi J, Weber K, Chilian W, Penn MS, Dong F. Role of SDF-1:CXCR4 in Impaired Post-Myocardial Infarction Cardiac Repair in Diabetes. Stem Cells Transl Med. 2018 Jan;7(1):115-124. 14.  Schiller NB, Shah PN, Crawford M. Recommenda-tions.for quantitation of the left ventricle by two-dimen-sional echocardiography. J Am Soc Echocardiogr 1989; 2: 258– 267.Platelet Markers and LVEF in CAD

Evaluation of surface expression of platelet markers and left ventricle ejection fraction in patients with coronary artery disease

https://journals.sbmu.ac.ir/smsj/article/download/30452/27626

Evaluation of surface expression of platelet markers and left ventricle ejection fraction in patients with coronary artery disease

Abstract

Similar works

Full text

Available Versions

Journals Portal, Shahid Beheshti University of Medical Sciences