Department of Cardiology, Wroclaw Medical University, Wroclaw, Poland.
Am J Ther. 2012 Jan;19(1):44-50. doi: 10.1097/MJT.0b013e3181e0cab3.
Endothelial progenitor cells (EPCs) play a key role in angiogenesis and vascular repair, although their exact functions are still disputable. The impact of EPC on left ventricular ejection fraction (LVEF) during acute myocardial infarction (MI) in patients treated with primary percutaneous coronary intervention (PCI) is also under investigation. The aim of this study was to assess the impact of different populations of EPC on LVEF during and 6 months after acute MI treated with primary PCI. The study included 34 patients with documented acute anterior wall MI. The control group consisted of 19 apparently healthy subjects. Blood for EPC assessments was obtained during the first 24 hours after MI and at 7 days and 6 months after PCI. CD34⁺/CD133⁺/CD45⁻, CD34⁺/CD31⁺/CD45⁻, CD34⁺/CD105⁺/CD45⁻, and CD31⁺/CD133⁺/CD45⁻ cell types were studied by flow cytometry. Echocardiography has been performed simultaneously with the EPC measurements. We observed a significant elevation of CD34⁺/CD133⁺/CD45⁻, CD34⁺/CD105⁺/CD45⁻, and CD31⁺/CD133⁺/CD45⁻ EPC at 7 days after PCI in comparison with 24 hours and 6 months after the MI. Patients with preserved LVEF at 7 days after PCI had also higher levels of CD31⁺/CD133⁺/CD45⁻. Acute anterior wall MI treated with primary PCI is followed by enhanced mobilization of EPC among which a high level of CD31⁺/CD133⁺/CD45⁻ subtype was strongly associated with the most preserved LVEF for up to 6 months after the index event. These data may provide some insight for future therapeutic strategies.
内皮祖细胞 (EPC) 在血管生成和血管修复中发挥着关键作用，尽管它们的确切功能仍存在争议。在接受经皮冠状动脉介入治疗 (PCI) 的急性心肌梗死 (MI) 患者中，EPC 对左心室射血分数 (LVEF) 的影响也在研究之中。本研究旨在评估在接受经皮冠状动脉介入治疗的急性 MI 患者中，不同群体的 EPC 对 MI 后即刻和 6 个月时 LVEF 的影响。本研究纳入了 34 例经证实的急性前壁 MI 患者。对照组包括 19 例健康志愿者。在 MI 后 24 小时内和 PCI 后 7 天和 6 个月时采集用于 EPC 评估的血液。通过流式细胞术研究 CD34⁺/CD133⁺/CD45⁻、CD34⁺/CD31⁺/CD45⁻、CD34⁺/CD105⁺/CD45⁻和 CD31⁺/CD133⁺/CD45⁻细胞类型。同时进行了超声心动图检查。我们观察到，与 MI 后 24 小时和 6 个月相比，PCI 后 7 天 CD34⁺/CD133⁺/CD45⁻、CD34⁺/CD105⁺/CD45⁻和 CD31⁺/CD133⁺/CD45⁻EPC 显著升高。与 7 天后 LVEF 保留的患者相比，CD31⁺/CD133⁺/CD45⁻水平较高。接受直接 PCI 治疗的急性前壁 MI 后，EPC 的动员增加，其中高水平的 CD31⁺/CD133⁺/CD45⁻亚型与指数事件后长达 6 个月的 LVEF 保留最密切相关。这些数据可能为未来的治疗策略提供一些见解。
