计划接受心脏再同步治疗的中重度左心室衰竭患者的祖细胞心脏摄取情况。

Cardiac uptake of progenitor cells in patients with moderate-to-severe left ventricular failure scheduled for cardiac resynchronization therapy.

作者信息

Goette Andreas, Jentsch-Ullrich Kathleen, Hammwöhner Matthias, Trautmann Silke, Franke Astrid, Klein Helmut U, Auricchio Angelo

机构信息

Division of Cardiology, University Hospital Magdeburg, Leipziger Street 44, 39120 Magdeburg Germany.

出版信息

Europace. 2006 Mar;8(3):157-60. doi: 10.1093/europace/euj042. Epub 2006 Feb 14.

DOI:10.1093/europace/euj042

PMID:16627431

Abstract

AIMS

Injury to the heart causes haematopoietic and endothelial progenitor cells (PCs) to migrate to the site of damage and to undergo PC differentiation, which may contribute to angiogenesis and myocardial tissue repair. We sought to determine the cardiac uptake of PC in patients with moderate-to-severe congestive heart failure (CHF) scheduled for cardiac resynchronization therapy.

METHODS AND RESULTS

A total of 28 patients was included in the study. Fourteen patients had moderate-to-severe CHF with a mean left ventricular ejection fraction (LVEF) of 20 +/- 9%. The remaining patients had a normal LVEF and served as controls. PCs (CD34(+) and CD34(+)/CD117(+)) were quantified using a fluorescence-activated cell sorter. In CHF patients, PCs were determined from whole blood samples taken from the aorta, the coronary sinus (CS), and the superior vena cava (SVC) during right and left heart catheterization. Cardiac PC uptake was determined as the difference in PC levels between the aorta and the CS. Differences in CD34(+)PC counts (Delta0.11 +/- 0.98 x 10(3) mL(-1)) and relative amount of CD34(+)/CD117(+)PC (Delta0.08 +/- 0.31%) between the aorta and the CS were not significant. PC levels were comparable between the SVC, CS, and aorta. CD34(+) and PC levels did not correlate with New York Heart Association class (r(2) = 0.22), LVEF (r(2) = 0.01), LV diameter (r(2) = 0.05), QRS complex duration (r(2) = 0.1), or maximal O(2) uptake during exercise (r(2) = 0.08). There was no difference between patients with ischaemic cardiomyopathy (ICM) and non-ICM. Systemic PC levels were not different compared with age-matched controls without LV failure (CD34(+): 4.61 +/- 1.83 x 10(3) mL(-1) vs. control: 5.25 +/- 1.67 x 10(3) mL(-1); P = n.s.).

CONCLUSION

Moderate-to-severe chronic CHF is not associated with elevated PC levels in the systemic circulation. A measurable cardiac uptake of CD34(+) and CD34(+)/CD117(+)PC cannot be demonstrated by FACS analysis in this cohort of patients.

摘要

目的

心脏损伤会促使造血和内皮祖细胞（PCs）迁移至损伤部位并发生PC分化，这可能有助于血管生成和心肌组织修复。我们试图确定计划接受心脏再同步治疗的中重度充血性心力衰竭（CHF）患者的心脏对PC的摄取情况。

方法与结果

本研究共纳入28例患者。14例患者患有中重度CHF，平均左心室射血分数（LVEF）为20±9%。其余患者LVEF正常，作为对照。使用荧光激活细胞分选仪对PCs（CD34(+)和CD34(+)/CD117(+)）进行定量分析。在CHF患者中，在左右心导管插入术期间从主动脉、冠状窦（CS）和上腔静脉（SVC）采集全血样本，测定PCs。心脏对PC的摄取量通过主动脉和CS之间PC水平的差异来确定。主动脉和CS之间CD34(+)PC计数差异（Δ0.11±0.98×10(3) mL(-1)）和CD34(+)/CD117(+)PC相对含量差异（Δ0.08±0.31%）不显著。SVC、CS和主动脉之间的PC水平相当。CD34(+)和PC水平与纽约心脏协会分级（r(2)=0.22）、LVEF（r(2)=0.01）、左心室直径（r(2)=0.05）、QRS波群时限（r(2)=0.1）或运动期间最大摄氧量（r(2)=0.08）均无相关性。缺血性心肌病（ICM）患者和非ICM患者之间无差异。与无左心室衰竭的年龄匹配对照组相比，全身PC水平无差异（CD34(+)：4.61±1.83×10(3) mL(-1) vs.对照组：5.25±1.67×10(3) mL(-1)；P=无显著性差异）。