Circulating endothelial progenitor cells in congestive heart failure
Mutsuko Nonaka-Sarukawa1, Keiji Yamamoto, Hirotaka Aoki
1Division of Cardiovascular Medicine, Jichi Medical University, Shimotsuke, Tochigi 329-0498, Japan.
Insights
Circulating endothelial progenitor cells (EPCs), measured as CD34+ MNCs, are reduced in severe congestive heart failure (CHF). This suggests impaired EPC function may contribute to severe CHF pathophysiology.
Area of Science:
- Cardiovascular Medicine
- Hematology
- Regenerative Medicine
Background:
- Endothelial progenitor cells (EPCs) are crucial for neovascularization and circulate in peripheral blood.
- EPCs are identified within CD34-positive mononuclear cells (CD34+ MNCs).
- The kinetics of circulating EPCs in congestive heart failure (CHF) remain underexplored.
Purpose of the Study:
- To investigate the levels of circulating CD34+ MNCs in patients with varying severity of CHF.
- To explore the relationship between CD34+ MNCs, clinical parameters, and disease progression in CHF.
Main Methods:
- Quantified CD34+ MNCs in peripheral blood using flow cytometry.
- Measured white blood cells (WBCs), brain natriuretic peptide (BNP), erythropoietin, vascular endothelial growth factor (VEGF), and thrombomodulin levels.
- Compared these parameters across mild CHF, severe CHF, and control groups.
Main Results:
- The ratio of CD34+ MNCs to WBCs was elevated in mild CHF but significantly reduced in severe CHF patients at admission.
- Severe CHF patients exhibited higher BNP and erythropoietin levels compared to mild CHF patients.
- In severe CHF, the CD34+ MNC ratio increased with clinical improvement and correlated with decreasing BNP levels.
Conclusions:
- A decreased ratio of CD34+ MNCs:10(3) WBCs is observed in severe CHF.
- Impaired endothelial progenitor cell recruitment may play a role in the pathophysiology of severe CHF.
Background:
Endothelial progenitor cells (EPCs) circulate in the adult peripheral blood and contribute to neovascularization. EPCs are considered to be included in CD34 positive mononuclear cells (CD34+ MNCs). Kinetics of circulating EPCs in congestive heart failure (CHF) has not been fully investigated.
Methods:
We determined the numbers of white blood cells (WBCs), plasma brain natriuretic peptide (BNP), serum erythropoietin, vascular endothelial growth factor (VEGF) and thrombomodulin levels in 16 mild CHF patients (NYHA I, II), 10 severe CHF patients with acute exacerbation (NYHA III, IV), and 22 control subjects. The number of CD34+ MNCs in peripheral blood was quantified by flow cytometry.
Results:
The ratio of CD34+ MNCs:10(3) WBCs in mild CHF patients was higher than that in control subjects (P<0.05). Interestingly, the ratio of CD34+ MNCs:10(3) WBCs in severe CHF patients at admission was significantly lower than that in control subjects (P<0.005) or in mild CHF patients (P<0.05). Levels of BNP and erythropoietin in severe CHF patients were significantly higher than those in mild CHF patients. However, VEGF and thrombomodulin levels were not different between mild and severe CHF patients. In addition, the ratio of CD34+ MNCs:10(3) WBCs in severe CHF patients increased in proportion to the amelioration of CHF during hospitalization, and this increase correlated with the decrease in BNP level.
Conclusions:
The ratio of CD34+ MNCs:10(3) WBCs was decreased in severe CHF. These findings suggest that impaired EPC recruitment might be involved in the pathophysiology of severe CHF.
