OC 18.2 - Plasma exosomes reflect myocardial injury detected by Cardiac Magnetic Resonance in STEMI patients

Sunday, July 10, 2022

11:00 AM – 11:15 AM

Location: ExCel Center, ICC Capital Suite Room 2-4

Presentation Format: In-Person

Presenting Author(s)

Marta Zarà, PhD

Researcher
Centro Cardiologico Monzino
Pavia, Lombardia, Italy

Co-Author(s)

AB

Andrea Baggiano

Cardiologist
Cantro Cardiologico Monzino IRCCS
Milano, Lombardia, Italy
CB

Cristina Banfi

Group Leader of the Proteomic Units
Centro Cardiologico Monzino IRCCS
Milan, Lombardia, Italy
JC

Jeness Campodonico

Cardiologist
Cantro Cardiologico Monzino IRCCS
Milano, Lombardia, Italy
CT

Calogero Tedesco

Biostatistic
Cantro Cardiologico Monzino IRCCS
milano, Lombardia, Italy
PA

Patrizia Amadio

Senior Scientist at the Heart and Brain Axis Unit
Centro Cardiologico Monzino IRCCS
Milan, Lombardia, Italy
SG

Sebastiano Gili

Cardiologist
Cantro Cardiologico Monzino IRCCS
Milano, Lombardia, Italy
GD

Gianluca De Dona

Student
Cantro Cardiologico Monzino IRCCS
Milano, Lombardia, Italy
Leonardo Sandrini, PhD

Post-Doc Fellow
Centro Cardiologico Monzino IRCCS
Milan, Lombardia, Italy
GM

Giancarlo Marenzi

Director of Intensive Cardiac Care Unit
Cantro Cardiologico Monzino IRCCS
Milano, Lombardia, Italy
GP

Gianluca Pontone

Director of Department of Cardiovascular Imaging
Cantro Cardiologico Monzino IRCCS
Milano, Lombardia, Italy
Silvia Stella Barbieri, PhD

Head of the Brain-Heart Axis Unit
Centro Cardiologico Monzino IRCCS
Milan, Lombardia, Italy

Background: Exosomes are a subgroup of extracellular vesicles released by cells and detectable in all body fluids. Their release and cargo are influenced by cellular microenvironment, thus mirroring cell/organ physio-pathological condition. The concentration and cargo of plasma exosomes released during ST-elevation myocardial infarction (STEMI) well reflect the clinical progression of the disease, suggesting their potential as biomarkers. Cardiac Magnetic Resonance (CMR) precisely detects STEMI-induced myocardial injury, by several parameters including microvascular obstruction (MVO) and myocardial salvage index (MSI), which predict functional recovery and risk of further cardiovascular events. However, it is not always applicable due to cost and availability reasons.

Aims: To assess whether plasma exosomes, specifically platelet-derived exosomes, reflect myocardial injury as detected by CMR after STEMI.

Methods: Fourty-two patients with STEMI were enrolled, underwent CMR within 1 week and concomitantly, blood was collected. Plasma exosomes were isolated by commercial kits, their concentration and size distribution determined by Nanoparticle Tracking Analysis, and GPIIbIIIa expression assessed by ELISA kit.

Results: Patients with anterior STEMI and those with late revascularization (>3 h from symptoms onset) displayed a higher number of circulating plasma exosomes (p < 0.001 and p< 0.05, respectively). Exosome dimension was smaller in patients with MVO (p < 0.01) and MSI < 0.5 (p < 0.05). Similarly, the expression of platelet marker GPIIbIIIa was lower in patients with anterior STEMI (p < 0.01) and MVO (p < 0.05). Specifically, exosome GPIIbIIIa expression and dimension significantly discriminated between patients with and without MVO in ROC curve analysis, with areas under the curve ranging from 0.70 to 0.77.

Conclusion(s): The main finding of our study is that plasma exosome profile well reflects CMR-assessed myocardial injury after STEMI. In particular, the exosome dimension and the expression of platelet marker GPIIbIIIa is independently associated with MVO. Future studies with larger populations are required to confirm the role of platelet-exosomes in risk stratification after STEMI.