title: Different clinical models of CD34 + cells mobilization in patients with cardiovascular disease.
abstract: To test the role of necrosis, ischemia or both in bone marrow cells (BMC) mobilization in patients with cardiovascular disease. We studied three groups of patients: group 1, Iatrogenic Necrosis, with pure necrosis (28 patients undergoing transcatheter radiofrequency ablation); group 2, Ischemic Necrosis (30 patients with myocardial infarction); group 3, Pure Ischemia (24 patients with unstable angina). As control groups, we studied 27 patients with stable coronary artery disease (CAD), and 20 patients without CAD undergoing angiography for valvular diseases or cardiomiopathy. CD34 + cells and cytokines were evaluated at: T(0) (baseline), 48 h and 5, 7, 10, 14 days thereafter. We observed a significant increase of CD34 + cells at T(3) and T(4) only in Iatrogenic Necrosis and Ischemic Necrosis group. The peak of mobilization was observed ten days after the necrotic event (2.8 ± 1.4 vs. 5.9 ± 1.9 in the group 1, P = 0.03; and 3 ± 1.5 vs. 5.6 ± 2 in the group 2, P = 0.04; respectively). We found a good correlation between CD34 + and vascular endothelial growth factor (VEGF) and stromal derived factor (SDF-1α) peak values (r = 0.77 and r = 0.63, respectively). At multivariable analysis, myocardial necrosis (OR 3.5, 95%CI 2.2-4.2, P < 0.01), VEGF (OR 2, 95%CI 1.1-3, P = 0.01 as above versus below median value), and SDF-1α (OR 1.6, 95%CI 1.1-2.5, P = 0.02 as above versus below median value) emerged as independent predictors of C34 + cells increase. Myocardial necrosis with simultaneous elevation of VEGF and SDF-1α causes a significant CD34 + cells mobilization in patients with cardiovascular disease.
authors.affiliation: U.O. Cardiologia, Cardiovascular Institute, Azienda Ospedaliero-Universitaria S.Anna, Ferrara, Italy. elisacangiano@aliceposta.it
authors.forename: Elisa
authors.initials: E
authors.lastname: Cangiano
authors.forename: Caterina
authors.initials: C
authors.lastname: Cavazza
authors.forename: Gianluca
authors.initials: G
authors.lastname: Campo
authors.forename: Marco
authors.initials: M
authors.lastname: Valgimigli
authors.forename: Gloria
authors.initials: G
authors.lastname: Francolini
authors.forename: Patrizia
authors.initials: P
authors.lastname: Malagutti
authors.forename: Claudio
authors.initials: C
authors.lastname: Pratola
authors.forename: Roberto
authors.initials: R
authors.lastname: Ferrari
mesh_terms: D000368:Aged; D018952:Antigens, CD34; D002318:Cardiovascular Diseases / Q000097:blood* / Q000628:therapy*; D054377:Chemokine CXCL12 / Q000097:blood*; D005260:Female; D019650:Hematopoietic Stem Cell Mobilization; D006801:Humans; D008297:Male; D008875:Middle Aged; D013234:Stem Cells; D013997:Time Factors; D042461:Vascular Endothelial Growth Factor A / Q000097:blood*
chemical_list: D018952:Antigens, CD34; C515255:CXCL12 protein, human; D054377:Chemokine CXCL12; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A