Brehm Michael, Picard F, Ebner P, Turan G, Bölke E, Köstering M, Schüller P, Fleissner T, Ilousis D, Augusta K, Peiper M, Schannwell Ch, Strauer B E
Department of Internal Medicine, Division of Cardiology, Pneumology and Angiology, Heinrich-Heine-University, Moorenstr. 5, 40 225 Düsseldorf, Germany.
Eur J Med Res. 2009 Sep 1;14(9):393-405. doi: 10.1186/2047-783x-14-9-393.
The aim of the present study was to determine whether regular exercise training (ET) is effective at promoting the mobilization of CPCs and improving their functional activity in patients with recently acquired myocardial infarction (STEMI). Regular physical training has been shown to improve myocardial perfusion and cardiovascular function. This may be related in part to a mobilization of bone marrow-derived circulating progenitor cells (CPCs) as well as an enhanced vascularisation.
37 patients with STEMI were randomly assigned to an ET group or a non-ET group (controls). Two weeks after STEMI, three weeks after regular ET and three months after ET, BNP levels, exercise echocardiography and exercise spiroergometry were evaluated. The number of CD34+/CD45+ and CD133+/CD45+ CPCs was measured by flow cytometry analysis. The migration capacity of the CPCs was determined with a boyden chamber and the clonogenic capacity by CFU-assay.
In the ET-group the number and migration capacity of CPCs increased significantly after regular exercise training. The BNP level decreased significantly from 121 +/- 94 to 75 +/- 47 pg/ml (p<0.001) after the ET period, the left ventricular ejection fraction raised in parallel at peak exercise, and the cardiorespiratory condition improved as demonstrated by an increase of VO2max (from 1641 +/- 522 to 1842 +/- 724 ml/min, p<0.02). These three effects persist till three months after the ET period.
Regular physical activity appears to predispose the mobilization and enhanced functional activity of CPCs, a phenomenon which might lead to an improved cardiac function in patients with recently acquired acute myocardial infarction.
本研究旨在确定规律运动训练（ET）是否能有效促进近期发生心肌梗死（STEMI）患者中循环祖细胞（CPCs）的动员并改善其功能活性。已有研究表明，规律的体育锻炼可改善心肌灌注和心血管功能。这可能部分与骨髓源性循环祖细胞（CPCs）的动员以及血管生成增强有关。
37例STEMI患者被随机分为ET组或非ET组（对照组）。在STEMI后两周、规律ET后三周以及ET后三个月，评估脑钠肽（BNP）水平、运动超声心动图和运动肺功能测试。通过流式细胞术分析测量CD34+/CD45+和CD133+/CD45+CPCs的数量。用博伊登小室测定CPCs的迁移能力，通过集落形成单位（CFU）测定法测定其克隆形成能力。
在ET组中，规律运动训练后CPCs的数量和迁移能力显著增加。ET期后，BNP水平从121±94显著降至75±47 pg/ml（p<0.001），运动峰值时左心室射血分数平行升高，并且如最大摄氧量增加所示（从1641±522增至1842±724 ml/min，p<0.02），心肺状况得到改善。这三种效应在ET期后持续三个月。
规律的体育活动似乎有利于CPCs的动员和功能活性增强，这一现象可能会改善近期发生急性心肌梗死患者的心脏功能。
