Impact of heterogeneity of human peripheral blood monocyte subsets on myocardial salvage in patients with primary acute myocardial infarction

J Am Coll Cardiol. 2009 Jul 7;54(2):130-8. doi: 10.1016/j.jacc.2009.04.021.


Objectives: We examined whether distinct monocyte subsets contribute in specific ways to myocardial salvage in patients with acute myocardial infarction (AMI).

Background: Recent studies have shown that monocytes in human peripheral blood are heterogeneous.

Methods: We studied 36 patients with primary AMI. Peripheral blood sampling was performed 1, 2, 3, 4, 5, 8, and 12 days after AMI onset. Two monocyte subsets (CD14(+)CD16(-) and CD14(+)CD16(+)) were measured by flow cytometry. The extent of myocardial salvage 7 days after AMI was evaluated by cardiovascular magnetic resonance imaging as the difference between myocardium at risk (T2-weighted hyperintense lesion) and myocardial necrosis (delayed gadolinium enhancement). Cardiovascular magnetic resonance imaging was also performed 6 months after AMI.

Results: Circulating CD14(+)CD16(-) and CD14(+)CD16(+) monocytes increased in AMI patients, peaking on days 3 and 5 after onset, respectively. Importantly, the peak levels of CD14(+)CD16(-) monocytes, but not those of CD14(+)CD16(+) monocytes, were significantly negatively associated with the extent of myocardial salvage. We also found that the peak levels of CD14(+)CD16(-) monocytes, but not those of CD14(+)CD16(+) monocytes, were negatively correlated with recovery of left ventricular ejection fraction 6 months after infarction.

Conclusions: The peak levels of CD14(+)CD16(-) monocytes affect both the extent of myocardial salvage and the recovery of left ventricular function after AMI, indicating that the manipulation of monocyte heterogeneity could be a novel therapeutic target for salvaging ischemic damage.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Angioplasty, Balloon, Coronary / methods*
  • Coronary Angiography
  • Electrocardiography
  • Female
  • Flow Cytometry
  • Follow-Up Studies
  • Humans
  • Lipopolysaccharide Receptors / blood*
  • Lipopolysaccharide Receptors / immunology
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Monocytes / immunology*
  • Myocardial Infarction / diagnosis
  • Myocardial Infarction / immunology*
  • Myocardial Infarction / therapy
  • Myocardium / immunology
  • Myocardium / pathology*
  • Necrosis / blood
  • Necrosis / immunology
  • Necrosis / pathology
  • Prognosis
  • Receptors, IgG / blood*
  • Receptors, IgG / immunology
  • Time Factors


  • Lipopolysaccharide Receptors
  • Receptors, IgG