Effects of exercise training on mobilization and functional activity of blood-derived progenitor cells in patients with acute myocardial infarction.
BACKGROUND
The aim of the present study was to determine whether regular exercise training (ET) is effective at promoting the mobilization of CPCs and improving their functional activity in patients with recently acquired myocardial infarction (STEMI). Regular physical training has been shown to improve myocardial perfusion and cardiovascular function. This may be related in part to a mobilization of bone marrow-derived circulating progenitor cells (CPCs) as well as an enhanced vascularisation.


METHODS
37 patients with STEMI were randomly assigned to an ET group or a non-ET group (controls). Two weeks after STEMI, three weeks after regular ET and three months after ET, BNP levels, exercise echocardiography and exercise spiroergometry were evaluated. The number of CD34+/CD45+ and CD133+/CD45+ CPCs was measured by flow cytometry analysis. The migration capacity of the CPCs was determined with a boyden chamber and the clonogenic capacity by CFU-assay.


RESULTS
In the ET-group the number and migration capacity of CPCs increased significantly after regular exercise training. The BNP level decreased significantly from 121 +/- 94 to 75 +/- 47 pg/ml (p<0.001) after the ET period, the left ventricular ejection fraction raised in parallel at peak exercise, and the cardiorespiratory condition improved as demonstrated by an increase of VO2max (from 1641 +/- 522 to 1842 +/- 724 ml/min, p<0.02). These three effects persist till three months after the ET period.


CONCLUSIONS
Regular physical activity appears to predispose the mobilization and enhanced functional activity of CPCs, a phenomenon which might lead to an improved cardiac function in patients with recently acquired acute myocardial infarction.
Brehm
Michael
M
Department of Internal Medicine, Division of Cardiology, Pneumology and Angiology, Heinrich-Heine-University, Moorenstr. 5, 40 225 Düsseldorf, Germany. brehm@med.uni-duesseldorf.de
Picard
F
F
Ebner
P
P
Turan
G
G
Bölke
E
E
Köstering
M
M
Schüller
P
P
Fleissner
T
T
Ilousis
D
D
Augusta
K
K
Peiper
M
M
Schannwell
Ch
Ch
Strauer
B E
BE
D000071916:AC133 Antigen; D000368:Aged; D015703:Antigens, CD / Q000097:blood; D018952:Antigens, CD34 / Q000097:blood; D001854:Bone Marrow Cells / Q000166:cytology / Q000378:metabolism*; D002465:Cell Movement / Q000502:physiology; D003131:Combined Modality Therapy; D025401:Echocardiography, Stress; D015444:Exercise / Q000502:physiology*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005434:Flow Cytometry; D006023:Glycoproteins / Q000097:blood; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D006412:Hematopoietic Stem Cells; D006801:Humans; D017493:Leukocyte Common Antigens / Q000097:blood; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000503:physiopathology / Q000534:rehabilitation*; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010455:Peptides / Q000097:blood; D011446:Prospective Studies; D013147:Spirometry
D000071916:AC133 Antigen; D015703:Antigens, CD; D018952:Antigens, CD34; D006023:Glycoproteins; C000606023:PROM1 protein, human; D010455:Peptides; D020097:Natriuretic Peptide, Brain; D017493:Leukocyte Common Antigens