title: Early outgrowth pro-angiogenic cell number and function do not correlate with left ventricular structure and function in conventional hemodialysis patients: a cross-sectional study.
abstract: BACKGROUND
  Left ventricular hypertrophy (LVH) is commonly found in chronic dialysis (CD) recipients, and is associated with impaired microvascular cardiac perfusion and heart failure. In response to LVH and cardiac ischemia, early outgrowth pro-angiogenic cellS(EPCs) mobilize from the bone marrow to facilitate angiogenesis and endothelial repair. In the general population, EPC number and function correlate inversely with cardiovascular risk. In end-stage renal disease (ESRD), EPC number and function are generally reduced.
  
  
  OBJECTIVE
  To test whether left ventricular abnormalities retain their potent ability to promote EPC reparative responses in the setting of ESRD.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  St. Michael's Hospital, Toronto, Ontario, Canada.
  
  
  METHODS
  47 prevalent chronic dialysis recipients.
  
  
  METHODS
  (1) circulating CD34(+) and CD133(+) EPC number, (2) cultured EPC migratory ability, in vitro differentiation potential, and apoptosis rate, and (3) cardiac magnetic resonance-measured LV mass, volume and ejection fraction.
  
  
  METHODS
  Bivariate correlation analysis was performed with Spearman's rho test.
  
  
  RESULTS
  Of the 47 patients (mean age: 54 ± 13 years), the mean delivered urea reduction was 74 ± 10 %. Mean LV mass was 123 ± 38 g. Circulating CD34(+) and CD133(+) EPCs represented 0.14 % (IQR: 0.05 - 0.29 %) and 0.05 % (IQR: 0.01 - 0.10 %) of peripheral blood mononuclear cells. There were no significant correlations between any EPC parameter and measures of LV mass or ejection fraction.
  
  
  CONCLUSIONS
  Lack of a non-ESRD control population, and the inability to measure all parameters of EPC function due to limitations in blood sampling. Our inability to measure cardiac VEGF expression prevented an assessment of changes in cardiac EPC mobilization signals.
  
  
  CONCLUSIONS
  These data suggest that in ESRD, the reparative EPC response to cardiac hypertrophy may be blunted. Further investigation of the effects of uremia on EPC physiology and its relationship to cardiac injury are required.
authors.affiliation: Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON Canada.
authors.forename: James R
authors.initials: JR
authors.lastname: Lineen
authors.affiliation: Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON Canada.
authors.forename: Michael
authors.initials: M
authors.lastname: Kuliszewski
authors.affiliation: Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON Canada.
authors.forename: Niki
authors.initials: N
authors.lastname: Dacouris
authors.affiliation: Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON Canada.
authors.forename: Christine
authors.initials: C
authors.lastname: Liao
authors.affiliation: Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON Canada.
authors.forename: Dmitriy
authors.initials: D
authors.lastname: Rudenko
authors.affiliation: Department of Medical Imaging, St. Michael's Hospital, Toronto, ON Canada.
authors.forename: Djeven P
authors.initials: DP
authors.lastname: Deva
authors.affiliation: Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON Canada.
authors.forename: Marc
authors.initials: M
authors.lastname: Goldstein
authors.affiliation: Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON Canada.
authors.forename: Howard
authors.initials: H
authors.lastname: Leong-Poi
authors.affiliation: Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON Canada.
authors.forename: Ron
authors.initials: R
authors.lastname: Wald
authors.affiliation: Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON Canada.
authors.forename: Andrew T
authors.initials: AT
authors.lastname: Yan
authors.affiliation: Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON Canada ; Division of Nephrology, St. Michael's Hospital, Li Ka Shing Knowledge Institute, Rm 509, 5th Floor, Toronto, ON M5B 2T2 Canada.
authors.forename: Darren A
authors.initials: DA
authors.lastname: Yuen
keywords: Cardiac magnetic resonance imaging; Early outgrowth pro-angiogenic cells; End-stage renal disease; Endothelial progenitor cells; Left ventricular hypertrophy