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[运动训练对急性心肌梗死后骨髓源性祖细胞动员、迁移能力及左心室射血分数的影响]

[Effects of exercise training on mobilization of BM-CPCs and migratory capacity as well as LVEF after AMI].

作者信息

Turan Ramazan Gökmen, Brehm Michael, Köstering Matthias, Bartsch Thomas, Zeus Tobias, Picard Frauke, Steiner Stephan, Fleissner Tillman, Ilousis Dimitrios, Augusta Karel, Kister Martin, Rüttger Claudia, Schannwell Christina Mira, Strauer Bodo Eckehard

机构信息

Klinik für Kardiologie, Pneumologie und Angiologie, Heinrich-Heine-Universität Düsseldorf.

出版信息

Med Klin (Munich). 2006 Mar 22;101 Suppl 1:198-201.

Abstract

BACKGROUND AND PURPOSE

Bone marrow-derived circulating progenitor cells (BM-CPCs) are mobilized in adult peripheral blood (PB) during the acute myocardial infarction (AMI) period and contribute to the regeneration of infarcted myocardium. In this study, the influence of physical training on the mobilization and the migratory activity of the BM-CPCs as well as on the left ventricular function (LVEF) after AMI was examined.

PATIENTS AND METHODS

26 patients with AMI were analyzed in two groups. The first group comprised 17 patients with standardized exercise training for 3 weeks 14 +/- 4 days after AMI, the second group nine control subjects without exercise training. PB concentrations of CD34/45+ and CD133/45+ were measured by FACS. The migratory activity of BM-CPCs was analyzed by migration assay. B-type natriuretic peptide (BNP) in PB and the functional investigations spiroergometry (VO2 and PaO2) and stress echocardiography (LVEF) were determined in both groups.

RESULTS

A significant increase in both concentrations, CD34/45+ and CD133/45+, as well as in migratory capacity of BM-CPCs was found after 3 weeks of exercise training, which was significantly decreased 3 months after completion of exercise training. No significant difference was observed in the control group without exercise training. In the functional investigations a significant increase in VO2 as well as PaO2 was shown spiroergometrically after exercise training. There was no difference in stress echocardiographic LVEF at rest in both groups. On the other hand, interestingly, the findings showed that the increase of LVEF at peak stress was significantly higher after exercise training as compared to the control group. Moreover, a significant decrease in BNP values was found after exercise training as well as 3 months after AMI. No difference was found in the control group.

CONCLUSION

This study demonstrates that exercise training for 3 weeks after AMI leads to a significant mobilization as well as increase of functional activation of BM-CPCs in humans. Moreover, regular exercise training might contribute to the positive effects on the regenerative potency after AMI.

摘要

背景与目的

骨髓来源的循环祖细胞(BM-CPCs)在急性心肌梗死(AMI)期间被动员至成人外周血(PB)中,并参与梗死心肌的再生。在本研究中,检测了体育锻炼对AMI后BM-CPCs的动员、迁移活性以及左心室功能(LVEF)的影响。

患者与方法

26例AMI患者被分为两组。第一组包括17例患者,在AMI后14±4天进行为期3周的标准化运动训练;第二组为9例未进行运动训练的对照受试者。通过流式细胞术检测PB中CD34/45+和CD133/45+的浓度。通过迁移试验分析BM-CPCs的迁移活性。两组均测定PB中的B型利钠肽(BNP)以及功能检查中的运动心肺功能测试(VO2和PaO2)和负荷超声心动图(LVEF)。

结果

运动训练3周后,CD34/45+和CD133/45+的浓度以及BM-CPCs的迁移能力均显著增加,运动训练结束3个月后显著下降。在未进行运动训练的对照组中未观察到显著差异。在功能检查中,运动训练后运动心肺功能测试显示VO2以及PaO2显著增加。两组静息时负荷超声心动图LVEF无差异。另一方面,有趣的是,研究结果表明,与对照组相比,运动训练后峰值负荷时LVEF的增加显著更高。此外,运动训练后以及AMI后3个月BNP值显著降低。对照组未发现差异。

结论

本研究表明,AMI后3周的运动训练可导致人体BM-CPCs的显著动员以及功能激活增加。此外,规律的运动训练可能有助于对AMI后再生潜能产生积极影响。

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