University of Leipzig, Heart Centre, Department of Internal Medicine/Cardiology, Germany
University of Leipzig, Heart Centre, Department of Internal Medicine/Cardiology, Germany.
Eur J Prev Cardiol. 2016 Mar;23(4):349-58. doi: 10.1177/2047487315588391. Epub 2015 May 26.
A reduction in number and function of endothelial progenitor cells (EPCs) occurs in both physiologic aging and chronic heart failure (CHF). We assessed whether disease and aging have additive effects on EPCs or whether beneficial effects of exercise training are diminished in old age.
We randomized 60 patients with stable CHF and 60 referent controls to a training or a control group. To detect possible aging effects we included subjects below 55 (young) and above 65 years (older). Subjects in the training group exercised four times daily at 60% to 70% of VO2max for four weeks under supervision. At baseline and after the intervention the number and function of EPCs were assessed.
As compared with young referent controls, older referent controls showed at baseline a reduced EPC number (young: 190 ± 37 CD34/KDR positive cells/ml blood; older: 131 ± 26 CD34/KDR positive cells/ml blood; p < 0.05) and function (young: 230 ± 41 migrated cells/1000 plated cells; older: 185 ± 28 cells/1000 plated cells; p < 0.05). In young and older CHF patients EPC-number (young: 85 ± 21 CD34/KDR positive cells/ml blood; older: 78 ± 20 CD34/KDR positive cells/ml blood) and EPC-function (young: 113 ± 26 cells/1000 plated cells; older: 120 ± 27 cells/1000 plated cells) were impaired. As a result of exercise training, EPC function improved by 24% in older referent controls (p < 0.05), while it remained unchanged in young training referent controls and controls respectively. In young and older patients with CHF four weeks of exercise training resulted in a significant improvement in EPC numbers and EPC function (young: number +66% function +43%; p < 0.05; older: number +69% function +36%; p < 0.05). These results were accompanied by a significant increase in flow mediated dilatation in the training groups of young/older CHF patients and in older referent controls.
Four weeks of exercise training are effective in improving EPC number and EPC function in CHF patients. These training effects were not impaired among older patients, emphasizing the potentials of rehabilitation interventions in a patient group where CHF has a high prevalence.
内皮祖细胞（EPC）的数量和功能减少发生在生理老化和慢性心力衰竭（CHF）中。我们评估了疾病和衰老是否对 EPC 具有相加作用，或者运动训练的有益作用是否在老年时减弱。
我们将 60 名稳定的 CHF 患者和 60 名对照患者随机分为训练组和对照组。为了检测可能的衰老影响，我们纳入了年龄在 55 岁以下（年轻）和 65 岁以上（年老）的患者。训练组的患者在监督下每天进行 4 次，每次 60%至 70%的最大摄氧量，持续四周。在基线和干预后，评估 EPC 的数量和功能。
与年轻的对照相比，年老的对照在基线时显示 EPC 数量减少（年轻：190±37 CD34/KDR 阳性细胞/ml 血液；年老：131±26 CD34/KDR 阳性细胞/ml 血液；p<0.05）和功能降低（年轻：230±41 迁移细胞/1000 个贴壁细胞；年老：185±28 细胞/1000 个贴壁细胞；p<0.05）。在年轻和年老的 CHF 患者中，EPC 数量（年轻：85±21 CD34/KDR 阳性细胞/ml 血液；年老：78±20 CD34/KDR 阳性细胞/ml 血液）和 EPC 功能（年轻：113±26 个细胞/1000 个贴壁细胞；年老：120±27 个细胞/1000 个贴壁细胞）受损。由于运动训练，年老的对照组 EPC 功能提高了 24%（p<0.05），而年轻的对照组和年轻的训练组则没有变化。在年轻和年老的 CHF 患者中，四周的运动训练导致 EPC 数量和 EPC 功能显著改善（年轻：数量增加 66%，功能增加 43%；p<0.05；年老：数量增加 69%，功能增加 36%；p<0.05）。这些结果伴随着年轻/年老的 CHF 患者训练组和年老的对照组的血流介导的扩张显著增加。
四周的运动训练能有效改善 CHF 患者的 EPC 数量和功能。这些训练效果在年老患者中没有受损，强调了康复干预在 CHF 高发患者群体中的潜力。
