Centre for Clinical and Basic Research, Istituto San Raffaele, Sulmona, Italy.
Int J Cardiol. 2012 Mar 22;155(3):409-13. doi: 10.1016/j.ijcard.2010.10.045. Epub 2010 Nov 20.
We studied the effect of a short-term (3 weeks) exercise training program on the number of circulating CD34/KDR(+) endothelial progenitor cells (EPCs) and on serum levels of matrix metalloproteinases (MMPs) in chronic heart failure (CHF) patients as well as on serum capacity to foster colony forming units-endothelial cells (CFU-ECs) in vitro.
Effectiveness of training was assessed by the 6-minute walking test (6MWT). Peripheral blood and serum were obtained from fourteen patients with CHF due to coronary artery disease before and after an inpatient aerobic exercise training program. At admission and at discharge we analysed circulating EPC number and serum levels of MMPs, TIMP-1 and TNF-α. The number and function of CFU-EC colonies were evaluated in cultures performed with serum obtained before and after training.
After training, distance walked at 6MWT and number of circulating CD34/KDR(+) cells increased (from 154 ± 27 to 233 ± 48 m; P<0.0001 and from 5 ± 3 to 9 ± 6 cells/ml P<0.05, respectively). Conversely, serum concentrations of MMP-1 and TIMP-1 decreased significantly (from 11.4 ± 2.4 to 6.3 ± 1.1 ng/ml, and from 320.4 ± 41.2 to 167.2 ± 12.6 ng/ml, respectively, both P<0.01), while MMP2/TIMP-1 and MMP-9/TIMP-1 ratios increased. Interestingly, we found increased CFU-EC proliferation in cultures performed with serum obtained after training.
Considering that both EPCs and MMPs might play a role in vascular remodeling, the increased number of EPCs and MMP activities observed in this study, suggest that the selected short-term exercise training could be a potential therapeutic strategy to rescue cardiac function in CHF patients.
我们研究了短期（3 周）运动训练计划对慢性心力衰竭（CHF）患者循环 CD34/KDR(+)内皮祖细胞（EPC）数量和血清基质金属蛋白酶（MMPs）水平的影响，以及对体外培养的集落形成单位-内皮细胞（CFU-EC）的血清形成能力的影响。
通过 6 分钟步行测试（6MWT）评估训练效果。从 14 名因冠状动脉疾病导致 CHF 的患者中采集外周血和血清，在入院和出院时分析循环 EPC 数量和血清 MMPs、TIMP-1 和 TNF-α 水平。用训练前后获得的血清评估 CFU-EC 集落的数量和功能。
训练后，6MWT 步行距离和循环 CD34/KDR(+)细胞数量增加（从 154±27 增加到 233±48 m；P<0.0001 和从 5±3 增加到 9±6 cells/ml，P<0.05）。相反，血清 MMP-1 和 TIMP-1 浓度显著降低（从 11.4±2.4 降低到 6.3±1.1 ng/ml，从 320.4±41.2 降低到 167.2±12.6 ng/ml，均 P<0.01），而 MMP2/TIMP-1 和 MMP-9/TIMP-1 比值增加。有趣的是，我们发现用训练后获得的血清进行培养时 CFU-EC 增殖增加。
鉴于 EPC 和 MMPs 都可能在血管重塑中发挥作用，本研究中观察到的 EPC 数量增加和 MMP 活性增加提示，选择的短期运动训练可能是一种潜在的治疗策略，可以挽救 CHF 患者的心脏功能。
