Neutrophil extracellular trap components and myocardial recovery in post-ischemic acute heart failure

Abstract

Objective The role of neutrophil extracellular traps (NETs) in acute heart failure is unknown. We recently showed that interleukin 8, a putative NETs stimulator, was associated with myocardial recovery in acute heart failure complicating ST-elevation myocardial infarction (STEMI). In this exploratory post-hoc study, we aimed to investigate the role of NETs components in relation to myocardial function and interleukin 8 in STEMI patients with symptomatic acute heart failure. Methods In 61 STEMI patients developing acute heart failure within 48 hours of successful revascularization, wall motion score index (WMSI), global longitudinal strain (GLS) and left ventricular ejection fraction (LVEF) were assessed by echocardiography at baseline and on day 5. Blood drawn at baseline and days 1, 2 and 5 was used to quantify double-stranded DNA (dsDNA), myeloperoxidase-DNA complexes (MPO-DNA) and citrullinated histone 3 (CitH3). The area under the curve (AUC) of each NETs marker and interleukin 8 was approximated for the first 5 days. Results dsDNA AUC and MPO-DNA AUC correlated significantly with change in WMSI from baseline to day 5 (r s = 0.28 for both, p≤0.05), whereas NETs AUCs did not correlate with changes in GLS and LVEF. dsDNA AUC was significantly correlated with interleukin 8 AUC (r = 0.40, p = 0.003). However, mixed model regression could not identify a significant effect of the NETs components on myocardial function parameters. Conclusions In this cohort with acute heart failure complicating STEMI, NETs components were partly correlated with myocardial function and interleukin 8 levels, yet no causal relationship between NETs components and myocardial recovery could be established. Clinical trial registration ClinicalTrials.gov, identifier: NCT00324766 .

White blood cell subtypes and neutrophil extracellular traps content as biomarkers for stroke etiology in acute ischemic stroke clots retrieved by mechanical thrombectomy

“…Particularly, CE clots have higher web-like NETs expression compared to both AT and cryptogenic clots, in accordance with the earlier findings [18,20,21]. A number of studies have shown that identification of circulating NETs in the blood is possible through detecting double-stranded DNA (dsDNA), MPO-DNA, citrullinated histones, and peptidyl arginine deiminase 4 (PAD4) [39,40]. Vallés et al demonstrated that plasma markers of NETs like CitH3 are significantly higher is AIS patients with undesirable outcomes demonstrating a potential prognostic value [41].…”

Fibrin to von Willebrand factor ratio in arterial thrombi is associated with plasma levels of inflammatory biomarkers and local abundance of extracellular DNA

“…For example, it would be of interest to establish the association of co-morbidities (malignancy, diabetes) with the VWF/fibrin/DNA content of thrombi, but this analysis requires a larger size sample. In view of the recent data that following interventional treatment of acute myocardial infarction NET-biomarkers in blood are partly correlated with myocardial recovery [53], our results S2) with 95% confidence intervals (dotted lines) is shown for CAD and AIS patients with atherosclerosis (in green; cross symbols show outliers identified as described in [39]). Red symbols: CAD and AIS patients without any signs of atherosclerosis and all PAD patients.…”

Potential Role of Neutrophil Extracellular Traps in Cardio-Oncology

“…One study reported that C-reactive protein induces a concentration-dependent NET synthesis in patients with heart failure [ 50 ]. A link has been proposed between NETs-related coronary microvascular and macrovascular thrombosis through some possible mechanisms, involving mitochondrial DNA, high-mobility group box 1, fibronectin extra domain A, and galectin-3 and pattern recognition receptors, leading to the increase of heart failure [ 51 , 52 , 53 , 54 ].…”