Biphasic response in number of stem cells and endothelial progenitor cells after left ventricular assist device implantation: A 6 month follow-up

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• 作者：Peter Ivak^a ; ^d ; Jan Pitha^b ; ^h ; ^{japi@ikem.cz" class="auth_mail" title="E-mail the corresponding author} ; Peter Wohlfahrt^b ; ^g ; Ivana Kralova Lesna^b ; Petr Stavek^b ; Vojtech Melenovsky^c ; Zora Dorazilova^c ; Marketa Hegarova^c ; Jitka Stepankova^c ; Jiri Maly^a ; Alena Sekerkova^f ; Dominika Turcani^a ; Ivan Netuka^a ; ^e
• 关键词：LVAD ; left ventricular assist device ; SC ; stem cells ; EPC ; endothelial progenitor cells ; MP ; microparticles
• 刊名：International Journal of Cardiology
• 出版年：2016
• 出版时间：1 September 2016
• 年：2016
• 卷：218
• 期：Complete
• 页码：98-103
• 全文大小：638 K

文摘

Continuous blood flow could have deleterious effects on endothelium and vascular health. This could have serious consequences in patients with heart failure treated with continuous flow left ventricular assist devices (LVAD). Therefore, we studied effect of LVAD on three circulating vascular biomarkers: stem cells (SC), endothelial progenitor cells (EPC) and microparticles (MP).

Methods

In 23 patients (5 women) with end-stage heart failure, SC, EPC and MP were measured before, and 3 and 6 months after implantation of LVAD (HeartMate II). SC were defined using determination of surface antigen expression as mononuclear CD34 +/CD45low + cells and EPC as mononuclear CD34 +/CD45low +/KDR + cells. MP concentrations were determined by ELISA method.

Results

Three months after LVAD implantation numbers of SC and EPC significantly decreased (p = 0.01 and p = 0.001, respectively). On the contrary, between 3rd and 6th month after implantation they significantly increased (p = 0.006 and p = 0.003, respectively).MP did not change significantly during the study despite exerting similar trend as SC and EPC.

Conclusions

Observed biphasic changes of SC and EPC might reflect two processes. First, shortly after LVAD implantation, improved tissue perfusion could lead to decrease in ischemic stimuli and ensuing decrease of SC and EPC. Second, continuous flow between 3rd and 6th month produced by LVAD could lead to increase of SC and EPC through activation of endothelium. This explanation could be supported also by similar trend in the changes of concentrations of MP.