Increased High Mobility Group Box-1 Protein Levels are Associated With Impaired Cardiopulmonary and Echocardiographic Findings After Acute Myocardial Infarction

Abstract Background Several markers of systemic inflammation seem to play an active role in the pathophysiology of acute coronary syndrome and its evolution. High mobility group box-1 (HMGB-1), a ubiquitous nuclear protein constitutively expressed in quiescent cells, was recently recognized as a newer critical mediator of inflammatory diseases. The present study aimed to evaluate the possible association between HMGB-1 levels and structural and functional indices of cardiovascular performance such as cardiopulmonary and Doppler-echocardiography indices in patients after acute myocardial infarction (MI). Methods and Results Fifty-four consecutive patients (mean age 58.3 years, 83% males) recovering from acute MI were included in the study protocol. All patients underwent Doppler-echocardiography, cardiopulmonary exercise, and HMGB-1 assay. HMGB-1 levels in acute MI patients were significantly higher compared with age- and body mass index–matched controls (14.8 ± 6.8 vs. 2.3 ± 1.0 ng/mL, P 2peak ) = 14.4 ± 4.2 mL·kg·min and a slope of increase in ventilation over carbon dioxide output (VE/VCO 2slope ) = 32.1 ± 6.2, whereas Doppler-echocardiography values were: left ventricular end-diastolic volume (LVEDV) = 53.4 ± 8.2 mL/m 2 ; left ventricular ejection fraction (LVEF) = 41.7 ± 7.0%. Multiple linear regression analysis (stepwise method) showed that VO 2peak (β = –0.276, P = .012), VE/VCO 2slope (β = 0.244, P = .005), LVEDV (β = 0.267, P = .018), peak creatine kinase-MB (β = 0.339, P = .004), peak Troponin I (β = 0.244, P = .002), and LVEF (β = –0.312, P = .021) were significantly associated with HMGB-1 levels. Conclusions The present study demonstrated that in postinfarction patients, HMGB-1 levels were significantly higher compared with controls, and significantly correlated with cardiopulmonary and Doppler-echocardiography parameters.