Decreased circulating endothelial progenitor cell levels in patients with heart failure with preserved ejection fraction.
OBJECTIVE
The purpose of this study was to explore the relationship between endothelial progenitor cell (EPC) levels, heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF).


METHODS
A total of 44 HFpEF patients, 40 HFrEF patients and 69 age-, gender- and comorbidity-matched controls were enrolled after evaluating their clinical manifestations and echocardiography findings. Flow cytometry with quantification of three EPC markers in peripheral blood samples was used to assess the number of circulating EPCs.


RESULTS
HFpEF and HFrEF patients had significantly decreased circulating EPC levels compared to controls. Among heart failure patients, patients with New York Heart Association functional class (FC) IV had fewer circulating EPCs compared to those with FC II and FC III (p = 0.053). A simple linear regression analysis of data showed that high sensitivity C-reactive protein, left ventricular ejection fraction, left atrium diameter and the ratio of medial early filling to early diastolic mitral annular velocity all correlated with the EPC count. In multivariate Cox regression analyses, both HFpEF and HFrEF were found to be independent predictors of a decreased EPC number.


CONCLUSIONS
HFpEF and HFrEF patients have decreased circulating EPC numbers, which is an indication of impaired endothelial turnover.
Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Hsinchu Branch, Hsinchu, Taiwan, ROC.
Chia-Hung
CH
Chiang
Po-Hsun
PH
Huang
Hsin-Bang
HB
Leu
Chien-Yi
CY
Hsu
Ko-Fan
KF
Wang
Jaw-Wen
JW
Chen
Shing-Jong
SJ
Lin
D000368:Aged; D002452:Cell Count; D003430:Cross-Sectional Studies; D042783:Endothelial Cells / Q000473:pathology*; D005260:Female; D005434:Flow Cytometry; D006333:Heart Failure / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D013234:Stem Cells / Q000473:pathology*; D013318:Stroke Volume / Q000502:physiology