内皮祖细胞群体与心外膜及微血管性冠状动脉疾病的关系——一项细胞、血管造影及生理学研究。
The relationship between endothelial progenitor cell populations and epicardial and microvascular coronary disease-a cellular, angiographic and physiologic study.
作者信息
Chan Kim H, Simpson Philippa J L, Yong Andy S, Dunn Louise L, Chawantanpipat Chirapan, Hsu Chijen, Yu Young, Keech Anthony C, Celermajer David S, Ng Martin K C
机构信息
Department of Cardiology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia; The Heart Research Institute, Sydney, New South Wales, Australia; Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
The Heart Research Institute, Sydney, New South Wales, Australia.
出版信息
PLoS One. 2014 Apr 15;9(4):e93980. doi: 10.1371/journal.pone.0093980. eCollection 2014.
BACKGROUND
Endothelial progenitor cells (EPCs) are implicated in protection against vascular disease. However, studies using angiography alone have reported conflicting results when relating EPCs to epicardial coronary artery disease (CAD) severity. Moreover, the relationship between different EPC types and the coronary microcirculation is unknown. We therefore investigated the relationship between EPC populations and coronary epicardial and microvascular disease.
METHODS
Thirty-three patients with a spectrum of isolated left anterior descending artery disease were studied. The coronary epicardial and microcirculation were physiologically interrogated by measurement of fractional flow reserve (FFR), index of microvascular resistance (IMR) and coronary flow reserve (CFR). Two distinct EPC populations (early EPC and late outgrowth endothelial cells [OECs]) were isolated from these patients and studied ex vivo.
RESULTS
There was a significant inverse relationship between circulating OEC levels and epicardial CAD severity, as assessed by FFR and angiography (r=0.371, p=0.04; r=-0.358, p=0.04; respectively). More severe epicardial CAD was associated with impaired OEC migration and tubulogenesis (r=0.59, p=0.005; r=0.589, p=0.004; respectively). Patients with significant epicardial CAD (FFR<0.75) had lower OEC levels and function compared to those without hemodynamically significant stenoses (p<0.05). In contrast, no such relationship was seen for early EPC number and function, nor was there a relationship between IMR and EPCs. There was a significant relationship between CFR and OEC function.
CONCLUSIONS
EPC populations differ in regards to their associations with CAD severity. The number and function of OECs, but not early EPCs, correlated significantly with epicardial CAD severity. There was no relationship between EPCs and severity of coronary microvascular disease.
背景
内皮祖细胞（EPCs）与预防血管疾病有关。然而，仅使用血管造影术的研究在将EPCs与心外膜冠状动脉疾病（CAD）严重程度相关联时报告了相互矛盾的结果。此外，不同类型的EPCs与冠状动脉微循环之间的关系尚不清楚。因此，我们研究了EPC群体与冠状动脉心外膜和微血管疾病之间的关系。
方法
对33例患有单纯左前降支动脉疾病的患者进行了研究。通过测量血流储备分数（FFR）、微血管阻力指数（IMR）和冠状动脉血流储备（CFR）对冠状动脉心外膜和微循环进行生理学检测。从这些患者中分离出两种不同的EPC群体（早期EPC和晚期内皮祖细胞[OECs]）并进行体外研究。
结果
通过FFR和血管造影评估，循环OEC水平与心外膜CAD严重程度之间存在显著的负相关（分别为r = 0.371，p = 0.04；r = -0.358，p = 0.04）。更严重的心外膜CAD与OEC迁移和管腔形成受损有关（分别为r = 0.59，p = 0.005；r = 0.589，p = 0.004）。与没有血流动力学显著狭窄的患者相比，患有显著心外膜CAD（FFR < 0.75）的患者OEC水平和功能较低（p < 0.05）。相比之下，早期EPC数量和功能未观察到这种关系，IMR与EPCs之间也没有关系。CFR与OEC功能之间存在显著关系。
结论
EPC群体在与CAD严重程度的关联方面存在差异。OECs的数量和功能而非早期EPCs与心外膜CAD严重程度显著相关。EPCs与冠状动脉微血管疾病严重程度之间没有关系。
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