Circulating endothelial cells in patients with heart failure and left ventricular dysfunction
Vicenta Martínez-Sales1, Ignacio Sánchez-Lázaro, Virtudes Vila
1Centro de Investigación, Hospital Universitario La Fe, Valencia, Spain. martinez vicsal@gva.es
Insights
Circulating endothelial cells (CEC) are elevated in heart failure patients, particularly during the acute phase. These CEC levels correlate with markers of vascular damage and could indicate worsening heart failure.
Area of Science:
- Cardiovascular Research
- Vascular Biology
- Biomarker Discovery
Background:
- Endothelial damage and angiogenesis vary in acute and chronic heart failure.
- Circulating endothelial cells (CEC) are recognized indicators of vascular damage.
Purpose of the Study:
- To investigate the changes in CEC levels throughout different heart failure stages.
- To explore the correlation between CEC and established markers of vascular damage and angiogenesis.
Main Methods:
- Studied 32 heart failure patients (acute and stable phases) and 32 controls.
- Quantified circulating markers: CEC, von Willebrand factor (vWF), soluble E-selectin (sEsel), vascular endothelial growth factor (VEGF), and thrombospondin-1.
Main Results:
- Heart failure patients exhibited significantly higher CEC, vWF, sEsel, and VEGF compared to controls.
- CEC, vWF, and VEGF levels were significantly elevated in the acute phase versus the stable phase of heart failure.
- CEC levels demonstrated a positive correlation with vWF and VEGF, with acute phase patients showing markedly increased CEC counts.
Conclusions:
- Elevated CEC levels in heart failure patients confirm their role as markers of endothelial damage, correlating with vWF.
- CEC levels are significantly associated with the acute phase of heart failure.
- CEC may serve as a valuable biomarker for detecting and monitoring the progression of heart failure.
Introduction And Aims:
Acute and chronic heart failure may manifest different degrees of endothelial damage and angiogenesis. Circulating endothelial cells (CEC) have been identified as marker of vascular damage. The aim of our study was to evaluate the evolution of the CEC at different stages of patients with heart failure. We also investigated a potential correlation between CEC and markers of vascular damage and angiogenesis.
Methods:
We studied 32 heart failure patients at hospital admission (acute phase) and at revision after 3 months (stable phase) and 32 controls. Circulating markers of endothelial damage (CEC; von Willebrand factor, vWF and soluble E-selectin, sEsel) and angiogenesis (vascular endothelial growth factor, VEGF and thrombospondin-1) were quantified.
Results:
Levels of CEC, vWF, sEsel and VEGF are significantly higher in heart failure patients than in controls. Levels of CEC (36.9 ± 15.3 vs. 21.5 ± 10.0 cells/ml; p< 0.001), vWF (325 ± 101 vs. 231 ± 82%; p< 0.001) and VEGF (26.3 ± 15.2 vs. 21.9 ± 11.9 ng/ml; p< 0.001) are significantly higher in the acute phase than in the stable phase of heart failure. CEC levels correlate with vWF and VEGF. RESULTS show than 100% of patients in acute phase and 37.5% in stable phase have levels of CEC higher than the 99th percentile of the distribution of controls (16 cells/ml). Therefore, increases in CEC represent a relative risk of 9.5 for heart failure patients suffering from acute phase.
Conclusions:
CEC, in addition to being elevated in heart failure, correlate with vWF levels, providing further support for CEC as markers of endothelial damage. Levels of CEC are associated with the acute phase of heart failure and could be used as a marker of the worsening in heart failure.
