Michowitz Yoav, Goldstein Emil, Wexler Dov, Sheps David, Keren Gad, George Jacob
The Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Heart. 2007 Sep;93(9):1046-50. doi: 10.1136/hrt.2006.102657. Epub 2007 Feb 3.
Circulating endothelial progenitor cells (EPCs) are increased in conditions associated with ischaemia and can potentially support angiogenesis and vasculogenesis. EPC levels were also shown to predict outcome in patients with atherosclerotic vascular disease. We tested the hypothesis that circulating EPC can predict outcome in patients with congestive heart failure (CHF).
EPC-colony-forming units were measured in the peripheral blood of 107 consecutive patients with CHF with New York Heart Association (NYHA) functional class II-IV. Serum levels of vascular endothelial growth factor (VEGF), N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) and high-sensitivity C-reactive protein (hsCRP) were also measured. End points were defined as CHF-related hospital admissions and all-cause mortality.
Age (p = 0.01), diabetes mellitus (p = 0.002) and EPC levels (p = 0.02) were found to be independent predictors of all-cause mortality. EPC levels did not predict CHF-related hospitalisations. EPC levels correlated positively with NYHA (p = 0.05, r = 0.19), but did not correlate with VEGF, NT-pro-BNP or hsCRP. EPC levels did not differ by the aetiology of CHF.
EPC levels are independent predictors of all-cause mortality among patients with CHF.
循环内皮祖细胞（EPCs）在与缺血相关的情况下会增加，并可能支持血管生成和血管发生。EPC水平也被证明可预测动脉粥样硬化性血管疾病患者的预后。我们检验了循环EPC可预测充血性心力衰竭（CHF）患者预后的假设。
对107例纽约心脏协会（NYHA）心功能II-IV级的连续CHF患者的外周血进行EPC集落形成单位检测。还检测了血管内皮生长因子（VEGF）、N末端B型脑钠肽原（NT-pro-BNP）和高敏C反应蛋白（hsCRP）的血清水平。终点定义为CHF相关的住院和全因死亡率。
年龄（p = 0.01）、糖尿病（p = 0.002）和EPC水平（p = 0.02）被发现是全因死亡率的独立预测因素。EPC水平不能预测CHF相关的住院情况。EPC水平与NYHA呈正相关（p = 0.05，r = 0.19），但与VEGF, NT-pro-BNP或hsCRP无相关性。CHF的病因不同，EPC水平无差异。
EPC水平是CHF患者全因死亡率的独立预测因素。
