HEART FAILURE AND CARDIOMYOPATHY

Circulating endothelial progenitor cells and clinical outcome in patients with congestive heart failure

Yoav Michowitz, Emil Goldstein, Dov Wexler, David Sheps, Gad Keren, Jacob George

The Department of Cardiology, Tel Aviv Sourasky Medical Center, affiliated to the Tel Aviv University, Sackler School of Medicine, Tel Aviv, Israel

Correspondence to:
Dr J George
The Department of Cardiology, Tel Aviv Sourasky Medical Center, 6 Weizmann street, Tel Aviv 64239, Israel; jacobg{at}post.tau.ac.il

Background: Circulating endothelial progenitor cells (EPCs) are increased in conditions associated with ischaemia and can potentially support angiogenesis and vasculogenesis. EPC levels were also shown to predict outcome in patients with atherosclerotic vascular disease. We tested the hypothesis that circulating EPC can predict outcome in patients with congestive heart failure (CHF).

Methods: EPC–colony-forming units were measured in the peripheral blood of 107 consecutive patients with CHF with New York Heart Association (NYHA) functional class II–IV. Serum levels of vascular endothelial growth factor (VEGF), N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) and high-sensitivity C-reactive protein (hsCRP) were also measured. End points were defined as CHF-related hospital admissions and all-cause mortality.

Results: Age (p = 0.01), diabetes mellitus (p = 0.002) and EPC levels (p = 0.02) were found to be independent predictors of all-cause mortality. EPC levels did not predict CHF-related hospitalisations. EPC levels correlated positively with NYHA (p = 0.05, r = 0.19), but did not correlate with VEGF, NT-pro-BNP or hsCRP. EPC levels did not differ by the aetiology of CHF.

Conclusions: EPC levels are independent predictors of all-cause mortality among patients with CHF.

Abbreviations: BNP, B-type natriuretic peptide; CFU, colony-forming unit; CHF, congestive heart failure; EPC, endothelial progenitor cell; HF, heart failure; hsCRP, high-sensitivity C-reactive protein; LVEF, left ventricular ejection fraction; NT-pro-BNP, N-terminal pro-B-type natriuretic peptide; NYHA, New York Heart Association; VEGF, vascular endothelial growth factor

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