title: Decreased CD34+ cell number is correlated with cardiac dysfunction in patients with acute exacerbation of COPD.
abstract: OBJECTIVE
  Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is associated with a higher risk of cardiovascular disease (CVD). Previous studies have indicated that the reduction of bone marrow-derived multipotent progenitors (CD34+ cells) may lead to reduced vascular repair capacity and may help to identify patients that pose an increased cardiovascular risk. However, the relationship between CD34+cells and CVD risk in AECOPD remains unclear. The aim of the present study was to assess CD34+ cell counts and their relationship with classical adverse cardiac outcome predictors in AECOPD.
  
  
  METHODS
  For our study, 27 patients with AECOPD (GOLD stage III, IV), 26 with stable COPD (GOLD stage III, IV), and 24 healthy controls were enrolled. CD34+ cells were enumerated, and plasma concentrations of N-terminal pro-B-type natriuretic peptide (NT-proBNP), a systemic inflammation marker (high-sensitivity C-reactive protein, hsCRP) and mobilisation marker (matrix metalloproteinase-9, MMP-9), were measured. Echocardiography was performed to evaluate cardiac dysfunction and pulmonary hypertension.
  
  
  RESULTS
  Compared with healthy controls, AECOPD patients had a significantly decreased CD34+ cell count (5.1 ± 2.6 versus 9.4 ± 3.6 × 10³/ml), especially in patients with a prior history of acute exacerbation. For patients with AECOPD, the CD34+ cell count was inversely correlated with NT-proBNP levels, pulmonary artery systolic pressure (PASP) and resting heart rate, and positively correlated with left ventricular ejection fraction (LVEF). In all three groups, CD34+ cell count was negatively correlated with hsCRP.
  
  
  CONCLUSIONS
  The circulating CD34+ cell count was decreased and correlated with cardiac dysfunction in AECOPD patients, and thus may account for the increased cardiovascular risk in this population.
authors.affiliation: Respiratory Department, The First Affiliated Hospital of Sun Yat-sen University, Institute of Respiratory Diseases of Sun Yat-sen University, Zhongshan Road, Guangzhou, Guangdong Province, People's Republic of China. Electronic address: liuyangli86@163.com.
authors.forename: Yangli
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Respiratory Department, The First Affiliated Hospital of Sun Yat-sen University, Institute of Respiratory Diseases of Sun Yat-sen University, Zhongshan Road, Guangzhou, Guangdong Province, People's Republic of China; Respiratory Department, The Affiliated Hospital of Hainan Medical College, Xueyuan Road, Haikou, Hainan Province, People's Republic of China. Electronic address: Liuxiaoran3192@163.com.
authors.forename: Xiaoran
authors.initials: X
authors.lastname: Liu
authors.affiliation: Respiratory Department, The First Affiliated Hospital of Sun Yat-sen University, Institute of Respiratory Diseases of Sun Yat-sen University, Zhongshan Road, Guangzhou, Guangdong Province, People's Republic of China.
authors.forename: Gengpeng
authors.initials: G
authors.lastname: Lin
authors.affiliation: Respiratory Department, The First Affiliated Hospital of Sun Yat-sen University, Institute of Respiratory Diseases of Sun Yat-sen University, Zhongshan Road, Guangzhou, Guangdong Province, People's Republic of China.
authors.forename: Longhua
authors.initials: L
authors.lastname: Sun
authors.affiliation: Respiratory Department, The First Affiliated Hospital of Sun Yat-sen University, Institute of Respiratory Diseases of Sun Yat-sen University, Zhongshan Road, Guangzhou, Guangdong Province, People's Republic of China.
authors.forename: Hui
authors.initials: H
authors.lastname: Li
authors.affiliation: Respiratory Department, The First Affiliated Hospital of Sun Yat-sen University, Institute of Respiratory Diseases of Sun Yat-sen University, Zhongshan Road, Guangzhou, Guangdong Province, People's Republic of China. Electronic address: xiecanmao@163.com.
authors.forename: Canmao
authors.initials: C
authors.lastname: Xie
mesh_terms: D000368:Aged; D018952:Antigens, CD34 / Q000032:analysis; D002097:C-Reactive Protein / Q000378:metabolism; D016022:Case-Control Studies; D002452:Cell Count; D018450:Disease Progression; D004452:Echocardiography; D005260:Female; D006339:Heart Rate; D006801:Humans; D006976:Hypertension, Pulmonary / Q000097:blood* / Q000503:physiopathology; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000097:blood; D008875:Middle Aged; D039902:Multipotent Stem Cells / Q000737:chemistry; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood* / Q000503:physiopathology; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology
chemical_list: D018952:Antigens, CD34; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D002097:C-Reactive Protein; D020780:Matrix Metalloproteinase 9
keywords: Acute exacerbation; CD34+ cells; CRP; Cardiac dysfunction; Chronic Obstructive Pulmonary Disease (COPD)