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

• 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
• DOI: 10.1016/S0167-5273(03)00033-0
• EISSN: 1874-1754
• ISSN: 0167-5273

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.