Positive effect of eplerenone treatment on endothelial progenitor cells in patients with chronic heart failure.
BACKGROUND
Endothelial progenitor cells (EPCs) are known to play a significant role in reendothelialization and vascular repair. Recently, a mineralocorticoid receptor was demonstrated to be expressed by EPCs. The study aimed to evaluate a potential influence of eplerenone treatment on the total number of EPCs in patients with chronic heart failure.


METHODS
Eighty-seven male patients with chronic heart failure were included (age: 23-83 years; body mass index 29.1 ± 5.1 kg/m²; New York Heart failure classification (NYHA) I: 29 patients, NYHA II: 32 patients, NYHA III: 26 patients). Numbers of circulating EPCs were quantified immediately using flow cytometry. Twenty-eight patients received therapy with eplerenone. Patients were further characterized by echocardiography, spirometry and laboratory markers.


RESULTS
Patients with ongoing eplerenone administration showed higher levels of circulating cells expressing CD34+ (p<0.05) and CD34+KDR+ (p<0.05) and CD34+CD133+KDR+ cells (p<0.05). The effects of eplerenone treatment could be shown to be independent of NYHA status, genesis of the underlying cardiovascular morbidity, left ventricular function and co-medication.


CONCLUSIONS
Patients with chronic heart failure treated with eplerenone show higher numbers of EPCs. The clinical benefit for treatment with eplerenone has been demonstrated even for patients with mild heart failure and might be partially mediated by EPCs.
First Department of Medicine, Friedrich-Schiller-University Jena, Germany. christian.jung@med.uni-jena.de
Christian
C
Jung
Anna
A
Florvaag
Volker
V
Oberle
Michael
M
Fritzenwanger
Daniel
D
Kretschmar
Friedhelm
F
Kuethe
Stefan
S
Betge
Bjoern
B
Goebel
Marcus
M
Franz
Dagmar
D
Barz
Markus
M
Ferrari
Hans R
HR
Figulla
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D042783:Endothelial Cells / Q000473:pathology*; D000077545:Eplerenone; D015444:Exercise; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013148:Spironolactone / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D013234:Stem Cells / Q000187:drug effects* / Q000473:pathology*; D014463:Ultrasonography; D055815:Young Adult
D013148:Spironolactone; D000077545:Eplerenone