Roles of ghrelin in left-ventricular remodelling after acute myocardial infarction

Objective The purpose of this study was to elucidate the role of ghrelin after acute myocardial infarction (AMI) in left ventricular (LV) remodelling. Design Prospective observational study. Setting Jichi Medical University Hospital. Patients Fifty consecutive patients experiencing their first AMI. Interventions Ghrelin was measured on the day of admission, day 7, day 14 and 6months after AMI. Patients were treated by percutaneous coronary intervention, and successful myocardial reperfusion was accomplished within 12h after onset. To analyse LV remodelling, the authors performed left ventriculographies on the day of admission and 6months after AMI. Main outcome measures Changes in LV volume. Results Plasma ghrelin increased significantly after AMI (admission: 40.967.3; day 7: 89.5611.0; day 14: 92.6611.8fmol/ml, p<0.0001). There was a significant correlation between ghrelin on day 14 and changes in LV volume over 6months (r¼+0.46, p<0.001). Multivariate regression analysis showed that ghrelin on day 14 is a significant predictor of LV remodelling after AMI (b¼ +0.44, p¼0.001). Conclusion To our knowledge, this is the first report that shows a relation between circulating ghrelin after AMI and the progression of LV remodelling in the chronic phase. The elevation of ghrelin after AMI might be a compensatory mechanism to attenuate LV remodelling.