Circulating T-Cell Subsets, Monocytes, and Natural Killer Cells in Peripartum Cardiomyopathy: Results From the Multicenter IPAC Study

Charles F McTiernan; Penelope Morel; Leslie T Cooper; Navin Rajagopalan; Vinay Thohan; Mark Zucker; John Boehmer; Biykem Bozkurt; Paul Mather; John Thornton; Jalal K Ghali; Karen Hanley-Yanez; James Fett; Indrani Halder; Dennis M McNamara; James D Fett; Jessica Pisarcik; Charles McTiernan; John Gorcsan; Erik Schelbert; Rami Alharethi; Kismet Rasmusson; Kim Brunisholz; Amy Butler; Deborah Budge; A.G Kfoury; Benjamin Horne; Joe Tuinei; Heather Brown; Julie Damp; Allen J Naftilan; Jill Russell; Darla Freehardt; Eileen Hsich; Cynthia Oblak; Greg Ewald; Donna Whitehead; Jean Flanagan; Anne Platts; Uri Elkayam; Jorge Caro; Stephanie Mullin; Michael M Givertz; M. Susan Anello; David Booth; Tiffany Sandlin; Wendy Wijesiri; Lori A Blauwet; Joann Brunner; Mary Phelps; Ruth Kempf; Kalgi Modi; Tracy Norwood; Joan Briller; Decebal Sorin Griza; G. Michael Felker; Robb Kociol; Patricia Adams; Gretchen Wells; Deborah Wesley-Farrington; Sandra Soots; Richard Sheppard; Caroline Michel; Nathalie Lapointe; Heather Nathaniel; Angela Kealey; Marc Semigran; Maureen Daher; David Silber; Eric Popjes; Patricia Frey; Todd Nicklas; Jeffrey Alexis; Lori Caufield; John W Thornton; Mindy Gentry; Vincent J.B Robinson; Gyanendra K Sharma; Joan Holloway; Maria Powell; David Markham; Mark Drazner; Lynn Fernandez; David A Baran; Martin L Gimovsky; Natalia Hochbaum; Bharati Patel; Laura Adams; Gautam Ramani; Stephen Gottlieb; Shawn Robinson; Stacy Fisher; Joanne Marshall; Jennifer Haythe; Donna Mancini; Rachel Bijou; Maryjane Farr; Marybeth Marks; Henry Arango; Mariana Bolos; Sharon Rubin; Raphael Bonita; Susan Eberwine; Hal Skopicki; Kathleen Stergiopoulos; Ellen McCathy-Santoro; Jennifer Intravaia; Elizabeth Maas; Jordan Safirstein; Audrey Kleet; Nancy Martinez; Christine Corpoin; Donna Hesari; Sandra Chaparro; Laura J Hudson; Zora Injic; Ilan S Wittstein; IPAC Investigators

doi:10.1016/j.cardfail.2017.10.012

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Circulating T-Cell Subsets, Monocytes, and Natural Killer Cells in Peripartum Cardiomyopathy: Results From the Multicenter IPAC Study

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Circulating T-Cell Subsets, Monocytes, and Natural Killer Cells in Peripartum Cardiomyopathy: Results From the Multicenter IPAC Study

Charles F McTiernan, Penelope Morel, Leslie T Cooper, Navin Rajagopalan, Vinay Thohan, Mark Zucker, John Boehmer, Biykem Bozkurt, Paul Mather, John Thornton, …

Journal of cardiac failure, Vol.24(1), pp.33-42

2018-01

DOI: https://doi.org/10.1016/j.cardfail.2017.10.012

PMCID: PMC6467571

PMID: 29079307

Abstract

Cardiomyopathies

cellular immunity

flow cytometry

peripartum period

•Immune cell subsets were examined in healthy postpartum and peripartum cardiomyopathy (PPCM) women.•In the early postpartum, PPCM women had lower NK and higher CD3+CD4–CD8–CD38+ T cell levels.•Levels largely normalized by 6 months postpartum. The aim of this work was to evaluate the hypothesis that the distribution of circulating immune cell subsets, or their activation state, is significantly different between peripartum cardiomyopathy (PPCM) and healthy postpartum (HP) women. PPCM is a major cause of maternal morbidity and mortality, and an immune-mediated etiology has been hypothesized. Cellular immunity, altered in pregnancy and the peripartum period, has been proposed to play a role in PPCM pathogenesis. The Investigation of Pregnancy-Associated Cardiomyopathy (IPAC) study enrolled 100 women presenting with a left ventricular ejection fraction of <0.45 within 2 months of delivery. Peripheral T-cell subsets, natural killer (NK) cells, and cellular activation markers were assessed by flow cytometry in PPCM women early (<6 wk), 2 months, and 6 months postpartum and compared with those of HP women and women with non–pregnancy-associated recent-onset cardiomyopathy (ROCM). Entry NK cell levels (CD3–CD56+CD16+; reported as % of CD3– cells) were significantly (P < .0003) reduced in PPCM (6.6 ± 4.9% of CD3– cells) compared to HP (11.9 ± 5%). Of T-cell subtypes, CD3+CD4–CD8–CD38+ cells differed significantly (P < .004) between PPCM (24.5 ± 12.5% of CD3+CD4–CD8– cells) and HP (12.5 ± 6.4%). PPCM patients demonstrated a rapid recovery of NK and CD3+CD4–CD8–CD38+ cell levels. However, black women had a delayed recovery of NK cells. A similar reduction of NK cells was observed in women with ROCM. Compared with HP control women, early postpartum PPCM women show significantly reduced NK cells, and higher CD3+CD4–CD8–CD38+ cells, which both normalize over time postpartum. The mechanistic role of NK cells and “double negative” (CD4–CD8–) T regulatory cells in PPCM requires further investigation.

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Collaboration types: Domestic collaboration
Citation topics: 1 Clinical & Life Sciences; 1.37 Cardiology - General; 1.37.2126 Peripartum Cardiomyopathy
Web Of Science research areas: Cardiac & Cardiovascular Systems
ESI research areas: Clinical Medicine

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Title: Circulating T-Cell Subsets, Monocytes, and Natural Killer Cells in Peripartum Cardiomyopathy: Results From the Multicenter IPAC Study
Creators: Charles F McTiernan - Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, Pennsylvania
Penelope Morel - Department of Immunology, University of Pittsburgh, Pittsburgh, Pennsylvania
Leslie T Cooper - Mayo Clinic, Jacksonville, Florida
Navin Rajagopalan - Gill Heart Institute, University of Kentucky, Lexington, Kentucky
Vinay Thohan - Gill Heart Institute, University of Kentucky, Lexington, Kentucky
Mark Zucker - Cardiac Transplant Center, Beth Israel Newark Medical Center, New Jersey
John Boehmer - Division of Cardiology, Penn State Hershey Medical Center, Hershey, Pennsylvania
Biykem Bozkurt - Winters Center for Heart Failure Research, Baylor College of Medicine, Houston, Texas
Paul Mather - Cardiovascular Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
John Thornton - Division of Cardiology, Georgia Regents University in Augusta, Augusta, Georgia
Jalal K Ghali - Division of Cardiology, Mercer University School of Medicine, Macon, Georgia
Karen Hanley-Yanez - Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, Pennsylvania
James Fett - Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, Pennsylvania
Indrani Halder - Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, Pennsylvania
Dennis M McNamara - Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, Pennsylvania
Dennis M McNamara - University of Pittsburgh Medical Center
James D Fett - University of Pittsburgh Medical Center
Jessica Pisarcik - University of Pittsburgh Medical Center
Charles McTiernan - University of Pittsburgh Medical Center
Karen Hanley-Yanez - University of Pittsburgh Medical Center
John Gorcsan - University of Pittsburgh Medical Center
Erik Schelbert - University of Pittsburgh Medical Center
Rami Alharethi - Intermountain Medical Center
Kismet Rasmusson - Intermountain Medical Center
Kim Brunisholz - Intermountain Medical Center
Amy Butler - Intermountain Medical Center
Deborah Budge - Intermountain Medical Center
A.G Kfoury - Intermountain Medical Center
Benjamin Horne - Intermountain Medical Center
Joe Tuinei - Intermountain Medical Center
Heather Brown - Intermountain Medical Center
Julie Damp - Vanderbilt University
Allen J Naftilan - Vanderbilt University
Jill Russell - Vanderbilt University
Darla Freehardt - Vanderbilt University
Eileen Hsich - Cleveland Clinic
Cynthia Oblak - Cleveland Clinic
Greg Ewald - Washington University, St. Louis
Donna Whitehead - Washington University, St. Louis
Jean Flanagan - Washington University, St. Louis
Anne Platts - Washington University, St. Louis
Uri Elkayam - University of Southern California
Jorge Caro - University of Southern California
Stephanie Mullin - University of Southern California
Michael M Givertz - Brigham and Women's Hospital
M. Susan Anello - Brigham and Women's Hospital
Navin Rajagopalan - University of Kentucky
David Booth - University of Kentucky
Tiffany Sandlin - University of Kentucky
Wendy Wijesiri - University of Kentucky
Leslie T Cooper - Mayo Clinic
Lori A Blauwet - Mayo Clinic
Joann Brunner - Mayo Clinic
Mary Phelps - Mayo Clinic
Ruth Kempf - Mayo Clinic
Kalgi Modi - Louisiana State University
Tracy Norwood - Louisiana State University
Joan Briller - University of Illinois
Decebal Sorin Griza - University of Illinois
G. Michael Felker - Duke University
Robb Kociol - Duke University
Patricia Adams - Duke University
Gretchen Wells - Wake Forest
Vinay Thohan - Wake Forest
Deborah Wesley-Farrington - Wake Forest
Sandra Soots - Wake Forest
Richard Sheppard - Jewish General
Caroline Michel - Jewish General
Nathalie Lapointe - Jewish General
Heather Nathaniel - Jewish General
Angela Kealey - University of Calgary
Marc Semigran - Massachusetts General
Maureen Daher - Massachusetts General
John Boehmer - Penn State Milton S. Hershey Medical Center
David Silber - Penn State Milton S. Hershey Medical Center
Eric Popjes - Penn State Milton S. Hershey Medical Center
Patricia Frey - Penn State Milton S. Hershey Medical Center
Todd Nicklas - Penn State Milton S. Hershey Medical Center
Jeffrey Alexis - University of Rochester
Lori Caufield - University of Rochester
John W Thornton - Georgia Health Sciences University
Mindy Gentry - Georgia Health Sciences University
Vincent J.B Robinson - Georgia Health Sciences University
Gyanendra K Sharma - Georgia Health Sciences University
Joan Holloway - Georgia Health Sciences University
Maria Powell - Georgia Health Sciences University
David Markham - University of Texas, Southwestern
Mark Drazner - University of Texas, Southwestern
Lynn Fernandez - University of Texas, Southwestern
Mark Zucker - Newark Beth Israel Medical Center
David A Baran - Newark Beth Israel Medical Center
Martin L Gimovsky - Newark Beth Israel Medical Center
Natalia Hochbaum - Newark Beth Israel Medical Center
Bharati Patel - Newark Beth Israel Medical Center
Laura Adams - Newark Beth Israel Medical Center
Gautam Ramani - University of Maryland
Stephen Gottlieb - University of Maryland
Shawn Robinson - University of Maryland
Stacy Fisher - University of Maryland
Joanne Marshall - University of Maryland
Jennifer Haythe - Columbia University
Donna Mancini - Columbia University
Rachel Bijou - Columbia University
Maryjane Farr - Columbia University
Marybeth Marks - Columbia University
Henry Arango - Columbia University
Biykem Bozkurt - Baylor College
Mariana Bolos - Baylor College
Paul Mather - Thomas Jefferson
Sharon Rubin - Thomas Jefferson
Raphael Bonita - Thomas Jefferson
Susan Eberwine - Thomas Jefferson
Hal Skopicki - Stony Brook University Medical Center
Kathleen Stergiopoulos - Stony Brook University Medical Center
Ellen McCathy-Santoro - Stony Brook University Medical Center
Jennifer Intravaia - Stony Brook University Medical Center
Elizabeth Maas - Stony Brook University Medical Center
Jordan Safirstein - Morristown Hospital
Audrey Kleet - Morristown Hospital
Nancy Martinez - Morristown Hospital
Christine Corpoin - Morristown Hospital
Donna Hesari - Morristown Hospital
Sandra Chaparro - University of Miami
Laura J Hudson - University of Miami
Jalal K Ghali - Harper University Hospital
Zora Injic - Harper University Hospital
Ilan S Wittstein - Johns Hopkins Hospital
IPAC Investigators
Publication Details: Journal of cardiac failure, Vol.24(1), pp.33-42
Publisher: Elsevier Inc
Grant note: HL102429 / National Institutes of Health (http://dx.doi.org/10.13039/100000002)
Language: English
Resource Type: Journal article
PMID: 29079307
PMCID: PMC6467571
Record Identifier: 991031614262102976