Circulating CD34+VEGFR-2+ endothelial progenitor cells correlate with revascularization-mediated long-term improvement of cardiac function in patients with coronary chronic total occlusions

Yuxiang Dai; Jia Huang; Yinyin Chen; Shufu Chang; Chenguang Li; Hao Lu; Daoyuan Ren; Feng Zhang; Zheyong Huang; Juying Qian; Lei Ge; Junbo Ge

doi:10.1016/j.ijcard.2020.08.031

Circulating CD34+VEGFR-2+ endothelial progenitor cells correlate with revascularization-mediated long-term improvement of cardiac function in patients with coronary chronic total occlusions

Int J Cardiol. 2021 Jan 1:322:1-8. doi: 10.1016/j.ijcard.2020.08.031. Epub 2020 Aug 15.

Authors

Yuxiang Dai¹, Jia Huang¹, Yinyin Chen², Shufu Chang¹, Chenguang Li¹, Hao Lu¹, Daoyuan Ren¹, Feng Zhang¹, Zheyong Huang¹, Juying Qian¹, Lei Ge¹, Junbo Ge³

Affiliations

¹ Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China.
² Department of Radiology, Zhongshan Hospital, Department of Medical Imaging, Shanghai Medical School, Fudan University, Shanghai Institute of Medical Imaging, Shanghai, China.
³ Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China. Electronic address: jbge@zs-hospital.sh.cn.

PMID: 32810548
DOI: 10.1016/j.ijcard.2020.08.031

Abstract

Background: Endothelial progenitor cells (EPCs) participate in angiogenesis and neocollateralization. This study assessed if circulating EPCs can predict long-term improvement of global left ventricular systolic function in patients with coronary chronic total occlusions (CTOs) underwent successful percutaneous coronary intervention (PCI).

Methods: In this single-center, prospective, observational study, 115 consecutive patients with CTOs were evaluated by standard transthoracic echocardiography (ECHO) before and 9-12 months after PCI. Numbers of circulating putative EPCs were determined by flow cytometry analysis of mononuclear cells isolated from peripheral blood samples drawn before and 72 h after PCI.

Results: At mean 11.3 ± 2.5 months post vs. before PCI (all P < .05): by SAQ-7 summary scores, angina frequency, physical limitation and quality of life scores were greater; by ECHO, LVEDd decreased and LVEF increased, which were more significant in patients with Rentrop grades 2/3 vs. 0/1. At 72 h post vs. before PCI, CD34⁺VEGFR-2⁺CD133^- (0.82 ± 0.32 × 10⁶/L vs. 1.00 ± 0.39 × 10⁶/L, P = .003), CD34⁺VEGFR-2⁺CD133⁺ (0.24 ± 0.12 × 10⁶/L vs. 0.27 ± 0.14 × 10⁶/L, P = .028), and CD14⁺Tie2⁺VEGFR-2⁺ (6.60 ± 3.32 × 10⁶/L vs. 7.82 ± 3.91 × 10⁶/L, P = .006) cell numbers were lower. The baseline levels of CD34⁺VEGFR-2⁺cells (P = .001) and CD14⁺Tie2⁺VEGFR-2⁺cells (P < .001) were association with the grade of collateralization. In addition, the baseline and peri-procedural decrease of circulating CD34⁺VEGFR-2⁺ cells correlated with the increase of LVEF (P < .001, P < .001, respectively) and the decrease of LVEDd (P = .022, P = .029, respectively) at follow-up.

Conclusions: In this small study, the baseline levels of circulating CD34⁺VEGFR-2+ EPCs and its reduction after successful revascularization of CTOs correlated with long-term improvement in global LV systolic function.

Keywords: Cardiac function; Coronary chronic total occlusions; Endothelial progenitor cells; Percutaneous coronary intervention.

Publication types

Observational Study

MeSH terms

Coronary Occlusion*
Endothelial Progenitor Cells*
Humans
Percutaneous Coronary Intervention*
Prospective Studies
Quality of Life
Vascular Endothelial Growth Factor Receptor-2

Substances

Vascular Endothelial Growth Factor Receptor-2