title: Circulating endothelial cells in patients with heart failure and left ventricular dysfunction.
abstract: OBJECTIVE
  Acute and chronic heart failure may manifest different degrees of endothelial damage and angiogenesis. Circulating endothelial cells (CEC) have been identified as marker of vascular damage. The aim of our study was to evaluate the evolution of the CEC at different stages of patients with heart failure. We also investigated a potential correlation between CEC and markers of vascular damage and angiogenesis.
  
  
  METHODS
  We studied 32 heart failure patients at hospital admission (acute phase) and at revision after 3 months (stable phase) and 32 controls. Circulating markers of endothelial damage (CEC; von Willebrand factor, vWF and soluble E-selectin, sEsel) and angiogenesis (vascular endothelial growth factor, VEGF and thrombospondin-1) were quantified.
  
  
  RESULTS
  Levels of CEC, vWF, sEsel and VEGF are significantly higher in heart failure patients than in controls. Levels of CEC (36.9 ± 15.3 vs. 21.5 ± 10.0 cells/ml; p< 0.001), vWF (325 ± 101 vs. 231 ± 82%; p< 0.001) and VEGF (26.3 ± 15.2 vs. 21.9 ± 11.9 ng/ml; p< 0.001) are significantly higher in the acute phase than in the stable phase of heart failure. CEC levels correlate with vWF and VEGF. RESULTS show than 100% of patients in acute phase and 37.5% in stable phase have levels of CEC higher than the 99th percentile of the distribution of controls (16 cells/ml). Therefore, increases in CEC represent a relative risk of 9.5 for heart failure patients suffering from acute phase.
  
  
  CONCLUSIONS
  CEC, in addition to being elevated in heart failure, correlate with vWF levels, providing further support for CEC as markers of endothelial damage. Levels of CEC are associated with the acute phase of heart failure and could be used as a marker of the worsening in heart failure.
authors: Centro de Investigación, Hospital Universitario La Fe, Valencia, Spain. martinez vicsal@gva.es
authors: Vicenta
authors: V
authors: Martínez-Sales
authors: Ignacio
authors: I
authors: Sánchez-Lázaro
authors: Virtudes
authors: V
authors: Vila
authors: Luis
authors: L
authors: Almenar
authors: Teresa
authors: T
authors: Contreras
authors: Edelmiro
authors: E
authors: Reganon
mesh_terms: D000368:Aged; D042501:Angiogenic Proteins / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002452:Cell Count; D042783:Endothelial Cells / Q000473:pathology*; D006333:Heart Failure / Q000097:blood* / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018919:Neovascularization, Physiologic; D018487:Ventricular Dysfunction, Left / Q000097:blood* / Q000473:pathology*
chemical_list: D042501:Angiogenic Proteins; D015415:Biomarkers