Sustained myocardial production of stromal cell-derived factor-1α was associated with left ventricular adverse remodeling in patients with myocardial infarction

The role of stromal cell-derived factor-1 alpha (SDF-1 alpha) expressed in infarcted myocardium is unknown in humans. We examined whether SDF-1 alpha produced in an infarcted myocardial lesion may play a role in left ventricle (LV) remodeling and dysfunction in patients with acute myocardial infarction (AMI). We measured SDF-1 alpha levels in plasma obtained from aortic root (AO) and anterior interventricular vein (AIV) in the early phase (2 wk after MI) and the chronic phase (6 mo after MI) in 80 patients with anterior MI. An increment in SDF-1 alpha level from AO to AIV, reflecting SDF-1 alpha release from infarcted myocardium, was more frequent in patients with MI in the early phase of MI [n = 52 (65%), P = 0.03] but not in the chronic phase of MI [n = 46 (58%), P = 0.11] compared with that in control patients [n = 6/17 (35%)]. On linear regression analysis, the transmyocardial gradient in SDF-1 alpha level in the chronic phase of MI was correlated with percentage changes in LV end-diastolic volume index (r = 0.39, P = 0.001), LV end-systolic volume index (r = 0.38, P = 0.001), and LV ejection fraction (r = -0.26, P = 0.01) 6 mo after AMI. By contrast, the transmyocardial gradient of SDF-1 alpha in the early phase of MI had no significant correlations. In conclusion, the production of SDF-1 alpha in infarcted myocardium in the chronic phase of MI was associated with LV adverse remodeling and progressive dysfunction in AMI survivors.