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Title: Improvement in circulating endothelial progenitor cells pool after cardiac resynchronization therapy: increasing the list of benefits
Authors: Cristovão, Gonçalo 
Milner, James 
Sousa, Pedro
Ventura, Miguel 
Cristóvão, João
Elvas, Luís 
Paiva, Artur 
Gonçalves, Lino 
Ribeiro, Carlos Fontes 
António, Natália 
Keywords: Endothelial progenitor cells; Cardiac resynchronization therapy; Heart failure; Prognosis
Issue Date: 24-May-2020
Publisher: Springer Nature
Project: research grant from St Jude Medical and consulting fees from Boston Scientific 
Serial title, monograph or event: Stem Cell Research and Therapy
Volume: 11
Issue: 1
Abstract: Background: Recent studies suggest that circulating endothelial progenitor cells (EPCs) may influence the response to cardiac resynchronization therapy (CRT). The aim of this study was to evaluate the effect of CRT on EPC levels and to assess the impact of EPCs on long-term clinical outcomes. Population and methods: Prospective study of 50 patients submitted to CRT. Two populations of circulating EPCs were quantified previously to CRT implantation: CD34+KDR+ and CD133+KDR+ cells. EPC levels were reassessed 6 months after CRT. Endpoints during the long-term follow-up were all-cause mortality, heart transplantation, and hospitalization for heart failure (HF) management. Results: The proportion of non-responders to CRT was 42% and tended to be higher in patients with an ischemic vs non-ischemic etiology (64% vs 35%, p = 0.098). Patients with ischemic cardiomyopathy (ICM) showed significantly lower CD34+KDR+ EPC levels when compared to non-ischemic dilated cardiomyopathy patients (DCM) (0.0010 ± 0.0007 vs 0.0030 ± 0.0024 cells/100 leukocytes, p = 0.032). There were no significant differences in baseline EPC levels between survivors and non-survivors nor between patients who were rehospitalized for HF management during follow-up or not. At 6-month follow-up, circulating EPC levels were significantly higher than baseline levels (0.0024 ± 0.0023 vs 0.0047 ± 0.0041 CD34+KDR+ cells/100 leukocytes, p = 0.010 and 0.0007 ± 0.0004 vs 0.0016 vs 0.0013 CD133+/KDR+ cells/100 leukocytes, p = 0.007). Conclusions: Patients with ICM showed significantly lower levels of circulating EPCs when compared to their counterparts. CRT seems to improve the pool of endogenously circulating EPCs and reduced baseline EPC levels seem not to influence long-term outcomes after CRT.
ISSN: 1757-6512
DOI: 10.1186/s13287-020-01713-8
Rights: openAccess
Appears in Collections:FMUC Medicina - Artigos em Revistas Internacionais
I&D ICBR - Artigos em Revistas Internacionais

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