Epicardial Adipose Tissue and IL-13 Response to Myocardial Injury Drives Left Ventricular Remodeling After ST Elevation Myocardial Infarction
Valentina Parisi, Serena Cabaro, Vittoria D’Esposito, Laura Petraglia, Maddalena Conte, Pasquale Campana, Gerardo Gerundo, M. Abitabile, Andrea Tuccillo, Maria Accadia, Giuseppe Comentale, Emanuele Pilato, Mario Sansone, Dario Leosco, Pietro Formisano
Abstract
Introduction. Left ventricular (LV) remodelling after ST-segment elevation myocardial infarction (STEMI) is explained only in part by the infarct size, and the inter-patient variability may be ascribed to different inflammatory response to myocardial injury. Epicardial adipose tissue (EAT) is a source of inflammatory mediators which directly modulates the myocardium. EAT increase is associated to several cardiovascular diseases, however its response to myocardial injury is currently unknown. Among inflammatory mediators, IL-13 seems to play protective role in LV regeneration, but its variations after STEMI have not been described yet. Purpose. In the present study we analysed the association between infarct-related changes of EAT and IL-13 in post-STEMI LV remodelling. Methods. We enrolled 100 patients with STEMI undergoing primary angioplasty. At the enrolment (T0) and after 3 months (T1), we measured EAT thickness by echocardiography and circulating levels of IL-13 by ELISA. Results. At T1, the 60% of patients displayed increased EAT thickness (EAT>0). EAT was directly associated to LV end-diastolic volume (r=0.42; p=0.014), LV end-systolic volume (r=0.42; p=0.013) and worse LV ejection fraction (LVEF) at T1 (r=-0.44; p=0.0094), independently of the infarct size. In the overall population IL-13 levels significantly decreased at T1 (p=0.0002). The IL-13 was directly associated to LVEF (r=0.42; p=0.017) and inversely related to EAT (r=-0.51; p=0.022), thus suggesting a protective role for IL-13. Conclusions. The variability of STEMI-induced ‘inflammatory response’ may be associated to the post-infarct LV remodelling. EAT thickness and IL-13 levels could be novel prognostic markers in STEMI patients.