sICAM-1 correlates with myocardial ICAM-1 expression in dilated cardiomyopathy

Background: Dilated cardiomyopathy (DCM) is etiopathogenically linked to intramyocardial inflammation, which is reflected by ICAM-1 abundance. We investigated whether soluble ICAM-1 (sICAM-1) levels in the sera of DCM patients are associated with intramyocardial ICAM-1 expression. Methods: Immunohis...

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Published in:	International journal of cardiology Vol. 91; no. 2; pp. 153 - 161
Main Authors:	Noutsias, Michel, Hohmann, Claudia, Pauschinger, Matthias, Schwimmbeck, Peter-Lothar, Ostermann, Karsten, Rode, Ullrich, Yacoub, Magdi H, Kühl, Uwe, Schultheiss, Heinz-Peter
Format:	Journal Article
Language:	English
Published:	Shannon Elsevier Ireland Ltd 01-10-2003 Elsevier Science
Subjects:	Adult Antigens, Differentiation, T-Lymphocyte - metabolism Biological and medical sciences Biopsy Cardiology. Vascular system Cardiomyopathy, Dilated - metabolism Cardiomyopathy, Dilated - physiopathology Digital image analysis Dilated cardiomyopathy ELISA Endothelium, Vascular - metabolism Endothelium, Vascular - pathology Endothelium, Vascular - physiopathology False Positive Reactions Female Heart Humans ICAM-1 Immune system Immunohistochemistry Inflammatory cardiomyopathy Intercellular Adhesion Molecule-1 - biosynthesis Male Medical sciences Middle Aged Multivariate Analysis Myocarditis. Cardiomyopathies Myocardium - metabolism Myocardium - pathology Predictive Value of Tests Sensitivity and Specificity sICAM-1 Solubility Statistics as Topic Stroke Volume - physiology Tissue Donors Immunohistochemistry AF, Area fraction hpf, High power field InfCM, Inflammatory cardiomyopathy ICAM-1 SVR, Surface–volume ratio sICAM-1 IOD, Integral optical density DCM, Dilated cardiomyopathy ICAM-1, Intercellular cell adhesion molecule-1 Inflammatory cardiomyopathy Dilated cardiomyopathy ROC, Receiver operating characteristic Digital image analysis AUC, Area under the curve sICAM-1, Soluble ICAM-1 ELISA Immune system Human Intercellular adhesion molecule 1 Pathogenesis Cardiovascular disease Inflammation Myocardial disease Adhesion Anatomic pathology Congestive hypertrophic cardiomyopathy Heart disease
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Summary:	Background: Dilated cardiomyopathy (DCM) is etiopathogenically linked to intramyocardial inflammation, which is reflected by ICAM-1 abundance. We investigated whether soluble ICAM-1 (sICAM-1) levels in the sera of DCM patients are associated with intramyocardial ICAM-1 expression. Methods: Immunohistochemically detected ICAM-1 expression was quantified semiquantitatively in endomyocardial biopsies from DCM patients ( n=45; n=17 females; age: 48±15 years) and from n=12 donor hearts (controls) by a human observer (baseline vs. enhanced expression) and quantitatively by a digital image analysis (DIA) system. The DIA-measured qualities were area fraction (AF), surface–volume ratio (SVR) and integral optical density (ID). The sICAM-1 levels of the DCM patients and n=12 healthy volunteers (controls) were measured by ELISA (means of duplicate measurements). Intramyocardial ICAM-1 expression and sICAM-1 levels were compared in these DCM patients. Results: Of the DCM patients, n=24 (53%) demonstrated statistically higher sICAM-1 levels compared to controls (>198 ng/ml). By semiquantitative and quantitative DIA evaluation, endothelial ICAM-1 abundance was present in n=25 (56%) of the DCM biopsies. sICAM-1 correlated significantly ( P<0.001) both with the semiquantitatively assessed and the DIA-measured ICAM-1-AF, the ICAM-1-SVR and the ICAM-1-ID. The positive predictive value of sICAM-1 measurements for intramyocardial ICAM-1 abundance was 96%, and the negative predictive value was 71%, with a receiver operating characteristic area under the curve of 0.93. Furthermore, sICAM-1 levels correlated with intramyocardial T-lymphocytic (CD2+/CD3+) infiltrates ( P<0.03). Conclusions: Measurement of non-invasively obtained sICAM-1 reliably reflects intramyocardial ICAM-1 expression and may therefore serve as a non-invasive marker of inflammatory activity in DCM.
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ISSN:	0167-5273 1874-1754
DOI:	10.1016/S0167-5273(03)00033-0