Relationship between exercise capacity, endothelial progenitor cells and cytochemokines in patients undergoing cardiac rehabilitation

Francesca Cesari; Francesco Sofi; Roberto Caporale; Andrea Capalbo; Rossella Marcucci; Claudio Macchi; Raffaele Molino Lova; Tommaso Cellai; Mauro Vannucci; Gian Franco Gensini; Rosanna Abbate; Anna Maria Gori

doi:10.1160/TH08-10-0644

Thrombosis and Haemostasis, Inhaltsverzeichnis

Thromb Haemost 2009; 101(03): 521-526
DOI: 10.1160/TH08-10-0644

Cardiovascular Biology and Cell Signalling

Schattauer GmbH

Relationship between exercise capacity, endothelial progenitor cells and cytochemokines in patients undergoing cardiac rehabilitation

Francesca Cesari

¹Department of Medical and Surgical Critical Care, Thrombosis Centre, Center for the Study at Molecular and Clinical Level of Chronic, Degenerative and Neoplastic Diseases to Develop Novel Therapies, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy

,

Francesco Sofi

¹Department of Medical and Surgical Critical Care, Thrombosis Centre, Center for the Study at Molecular and Clinical Level of Chronic, Degenerative and Neoplastic Diseases to Develop Novel Therapies, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy

⁶Centro S. Maria agli Ulivi, Fondazione Don Carlo Gnocchi Onlus IRCCS, Impruneta, Florence, Italy

,

Roberto Caporale

²Central Laboratory, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy

,

Andrea Capalbo

¹Department of Medical and Surgical Critical Care, Thrombosis Centre, Center for the Study at Molecular and Clinical Level of Chronic, Degenerative and Neoplastic Diseases to Develop Novel Therapies, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy

,

Rossella Marcucci

¹Department of Medical and Surgical Critical Care, Thrombosis Centre, Center for the Study at Molecular and Clinical Level of Chronic, Degenerative and Neoplastic Diseases to Develop Novel Therapies, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy

,

Claudio Macchi

³Cardiac Rehabilitation Unit, Don Gnocchi Foundation, Florence, Italy

,

Raffaele Molino Lova

³Cardiac Rehabilitation Unit, Don Gnocchi Foundation, Florence, Italy

⁴Cardiorespiratory Rehabilitation Unit, Don Gnocchi Foundation, Massa, Italy

,

Tommaso Cellai

⁵Unit Of Cardiologic Rehabilitation I.F.C.A. “Ulivella e Glicini”, Florence, Italy

,

Mauro Vannucci

⁵Unit Of Cardiologic Rehabilitation I.F.C.A. “Ulivella e Glicini”, Florence, Italy

,

Gian Franco Gensini

⁶Centro S. Maria agli Ulivi, Fondazione Don Carlo Gnocchi Onlus IRCCS, Impruneta, Florence, Italy

,

Rosanna Abbate

¹Department of Medical and Surgical Critical Care, Thrombosis Centre, Center for the Study at Molecular and Clinical Level of Chronic, Degenerative and Neoplastic Diseases to Develop Novel Therapies, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy

,

Anna Maria Gori

¹Department of Medical and Surgical Critical Care, Thrombosis Centre, Center for the Study at Molecular and Clinical Level of Chronic, Degenerative and Neoplastic Diseases to Develop Novel Therapies, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy

⁶Centro S. Maria agli Ulivi, Fondazione Don Carlo Gnocchi Onlus IRCCS, Impruneta, Florence, Italy

› Institutsangaben

Abstract

Summary

No data are available about the possible role of endothelial progenitor cells (EPCs), cytochemokines and N-terminal pro-brain natriuretic peptide (NT-proBNP) in determining a different response to short period of cardiologic rehabilitation (CR), as measured by the improvement of exercise capacity. In a population of 86 cardiac surgery patients, we evaluated the numbers of EPCs, pro- and anti-inflammatory cytokines (IL-6,IL-8, IL-10, IL-1ra), hs-C-reactive protein (CRP), vascular endothelial growth factor (VEGF) and NT-proBNP before (T1), and after 15 days of CR (T2). EPCs were measured by flow cytometry, and the exercise capacity was measured at T1 and T2 by using the six-minute walk test (6MWT). At T2, a significant increase of 6MWT (p<0.0001) was detected. No significant increase of EPCs was observed, while a significant (at least p<0.05) decrease in cytochemokines, CRP and NT-ProBNP levels was evidenced. By analyzing the median improvement of 6MWT, only patients with a median improvement ≥23% showed a significant (p<0.05) increase of EPCs at T2, with significant correlations between EPCs, VEGF and IL-10. On the contrary, in patients with a median improvement <23% a negative correlation between CRP and EPCs was observed. Finally, CD34+/KDR+ EPCs showed significant correlation with IL-8 at T1. In conclusion, a short period of CR intervention determines a different pattern of modifications for EPCs in relation to the improvement of exercise capacity.

Keywords

Endothelial progenitor cells - cytochemokines - cardiac rehabilitation - exercise capacity

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Referenzen

References
1 Insner JM, Asahara T. Angiogenesis and vasculo-genesis as therapeutic strategies for postnatal neovascularization. J Clin Invest 1999; 103: 1231-1236.
2 Orlic D, Kajstura J, Chimenti S. et al. Bone marrow cells regenerate infarcted myocardium. Nature 2001; 410: 701-705.
3 Hill JM, Zalos G, Halcox JP. et al. Circulating endothelial progenitor cells, vascular function, and cardiovascular risk. N Engl J Med 2003; 348: 593-600.
4 Laufs U, Werner N, Link A. et al. Physical training increases endothelial progenitor cells, inhibits neointima formation, and enhances angiogenesis. Circulation 2004; 109: 220-226.
5 Laufs U, Urhausen A, Werner N. et al. Running exercise of different duration and intensity: effect on endothelial progenitor cells in healthy subjects. Eur J Cardiovasc Prev Rehabil 2005; 12: 407-414.
6 Steiner S, Niessner A, Ziegler S. et al. Endurance training increases the number of endothelial progenitor cells in patients with cardiovascular risk and coronary artery disease. Atherosclerosis 2005; 181: 305-310.
7 Adams V, Lenk K, Linke A. et al. Increase of circulating endothelial progenitor cells in patients with coronary artery disease after exercise-induced ischemia. Arterioscler Thromb Vasc Biol 2004; 24: 684-690.
8 Hambrecht R, Adams V, Erbs S. et al. Regular physical activity improves endothelial function in patients with coronary artery disease by increasing phosphorylation of endothelial nitric oxide synthase. Circulation 2003; 107: 3152-3158.
9 Ozuyaman B, Ebner P, Niesler U. et al. Nitric oxide differentially regulates proliferation and mobilization of endothelial progenitor cells but not of hematopoietic stem cells. Thromb Haemost 2005; 94: 770-772.
10 Moore MA, Hattori K, Heissig B. et al. Mobilization of endothelial and haematopoietic stem and progenitor cells by adenovector-mediated elevation of serum levels of SDF-1, VEGF, and angiopoietin-1. Ann NY Acad Sci 2001; 938: 36-45.
11 Honold J, Lehmann R, Heeschen C. et al. Effects of granulocyte colony simulating factor on functional activities of endothelial progenitor cells in patients with chronic ischemic heart disease. Arterioscler Thromb Vasc Biol 2006; 26: 2238-2243.
12 Schomig K, Busch G, Steppich B. et al. Interleukin-8 is associated with circulating CD133+ progenitor cells in acute myocardial infarction. Eur Heart J 2006; 27: 1032-1037.
13 Paul JD, Powell TM, Thompson M. et al. Endothelial progenitor cell mobilization and increased intravascular nitric oxide in patients undergoing cardiac rehabilitation. J Cardiopulm Rehabil Prev 2007; 27: 65-73.
14 Cesari F, Caporale R, Marcucci R. et al. NTproBNP and the anti-inflammatory cytokines are correlated with endothelial progenitor cells’ response to cardiac surgery. Atherosclerosis 2008; 199: 138-146.
15 Practice guidelines for primary care physicians: 2003 ESH/ESC Hypertension guidelines.. ESH/ESC hypertension guidelines committee. Hypertension 2003; 21: 1779-1186.
16 Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care 2003; 26: 5-20.
17 Third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adult (Adult Treatment Panel III) final report. Circulation 2002; 106: 3143-3421.
18 Leon AS, Franklin BA, Costa F. et al. Cardiac rehabilitation and secondary prevention of coronary heart disease: an American Heart Association scientific statement from the Council on Clinical Cardiology (Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity), in collaboration with the American association of Cardiovascular and Pulmonary Rehabilitation. Circulation 2005; 111: 369-376.
19 ATS.. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med 2002; 166: 111-117.
20 Urbich C, Aicher A, Heeschen C. et al. Soluble factors released by endothelial progenitor cells promote migration of endothelial cells and cardiac resident progenitor cells. J Mol Cell Cardiol 2005; 39: 733-742.
21 Asahara T, Takahashi T, Masuda H. et al. VEGF contributes to postnatal neovascularization by mobilizing bone marrow-derived endothelial progenitor cells. EMBO J 1999; 18: 3964-3972.
22 Shintani S, Murohara T, Ikeda H. et al. Mobilization of endothelial progenitor cells in patients with acute myocardial infarction. Circulation 2001; 103: 2776-2779.
23 Verma S, Kuliszewski MA, Li SH. et al. C-reactive protein attenuates endothelial progenitor cell survival, differentiation, and function: further evidence of a mechanistic link between C-reactive protein and cardiovascular disease. Circulation 2004; 109: 2058-2067.