Endurance training increases the number of endothelial progenitor cells in patients with cardiovascular risk and coronary artery disease.
OBJECTIVE
As regular physical exercise improves endothelial dysfunction and promotes cardiovascular health, we investigated the effect of training on angiogenesis by measuring the number of circulating endothelial progenitor cells (EPC), the level of EPC-mobilizing growth factors and tested vascular function by flow-mediated dilation (FMD) in patients with coronary artery disease (CAD) and cardiovascular risk factors (CVRF). In addition, degradation products of the NO pathway (NOx) were determined.


RESULTS
Twenty patients with documented CAD and/or CVRF joined a 12-week supervised running training. Circulating EPCs--defined by the surface markers CD34, KDR and CD133--were measured at baseline and after exercise training by flow cytometry. We found a significant increase in circulating EPCs (2.9+/-0.4-fold increase; P < .0001), which was positively correlated with both, the change of FMD (r = .81, P < .001) and the increase of NOx synthesis (r = .83, P < .001). Plasma VEGF and erythropoietin did not change in response to exercise. However, we observed a positive correlation between the number of EPCs and erythropoietin at baseline (r = .70, P < .01) and after training (r = .73, P < .01).


CONCLUSIONS
Regular exercise training augments the number of circulating EPCs in patients with CVRF and CAD and is associated with improved vascular function and NO synthesis.
Steiner
Sabine
S
2nd Department of Medicine, Division of Angiology, University of Medicine, Waehringer Guertel 18-20, 1090 Vienna, Austria.
Niessner
Alexander
A
Ziegler
Sophie
S
Richter
Bernhard
B
Seidinger
Daniela
D
Pleiner
Johannes
J
Penka
Martina
M
Wolzt
Michael
M
Huber
Kurt
K
Wojta
Johann
J
Minar
Erich
E
Kopp
Christoph W
CW
D000328:Adult; D003324:Coronary Artery Disease / Q000453:epidemiology / Q000473:pathology / Q000503:physiopathology*; D004730:Endothelium, Vascular / Q000166:cytology* / Q000502:physiology; D004921:Erythropoietin / Q000378:metabolism; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D008297:Male; D008875:Middle Aged; D018919:Neovascularization, Physiologic / Q000502:physiology; D009566:Nitrates / Q000378:metabolism; D009569:Nitric Oxide / Q000378:metabolism; D009573:Nitrites / Q000378:metabolism; D010807:Physical Endurance / Q000502:physiology*; D012307:Risk Factors; D013234:Stem Cells / Q000166:cytology* / Q000502:physiology; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism; D014664:Vasodilation / Q000502:physiology
D009566:Nitrates; D009573:Nitrites; D042461:Vascular Endothelial Growth Factor A; D004921:Erythropoietin; D009569:Nitric Oxide