scholarly journals Improvement in circulating endothelial progenitor cells pool after cardiac resynchronization therapy: increasing the list of benefits

2020 ◽  
Author(s):  
Gonçalo Cristóvão ◽  
James Milner ◽  
Pedro Sousa ◽  
Miguel Ventura ◽  
João Cristóvão ◽  
...  
Keyword(s):  
Cardiac Resynchronization Therapy ◽  
Progenitor Cells ◽  
Endothelial Progenitor Cells ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Endothelial Progenitor ◽  
Circulating Endothelial Progenitor Cells ◽  
The Impact

Abstract Background Recent studies suggest that circulating endothelial progenitor cells (EPCs) may influence the response to cardiac resynchronization therapy (CRT). The aim of this study was to evaluate the effect of CRT on EPCs levels and to assess the impact of EPCs on long-term clinical outcomes. Population and methods Prospective study of 50 patients submitted to CRT. Two populations of circulating EPCs were quantified previously to CRT implantation: CD34 + KDR + and CD133 + KDR + cells. EPCs levels were reassessed 6 months after CRT. Endpoints during the long-term follow-up were all-cause mortality, heart transplantation and hospitalization for heart failure (HF) management. Results The proportion of non-responders to CRT was 42% and tended to be higher in patients with an ischemic vs non-ischemic etiology (64% vs 35%, p=0.098). Patients with ischemic cardiomyopathy (ICM) showed significantly lower CD34+KDR+ EPCs levels when compared to non-ischemic dilated cardiomyopathy patients (DCM) (0.0010 ± 0.0007 vs 0.0030 ± 0.0024 cells/100 leukocytes, p=0.032). There were no significant differences in baseline EPCs levels between survivors and non-survivors nor between patients who were rehospitalized for HF management during follow-up or not. At 6-month follow-up, circulating EPCs levels were significantly higher than baseline levels (0.0024 ± 0.0023 vs 0.0047 ± 0.0041 CD34 + KDR + cells/100 leukocytes, p=0.010 and 0.0007 ± 0.0004 vs 0.0016 vs 0.0013 CD133 + /KDR + cells/100 leukocytes, p=0.007). Conclusions Patients with ICM showed significantly lower levels of circulating EPCs when compared to their counterparts. CRT seems to improve the pool of endogenously circulating EPCs and reduced baseline EPCs levels seem not influence long-term outcomes after CRT.

scholarly journals Improvement in Circulating Endothelial Progenitor Cells Pool After Cardiac Resynchronization Therapy: Increasing the List of Benefits

2020 ◽  
Author(s):  
Gonçalo Cristóvão ◽  
James Milner ◽  
Pedro Sousa ◽  
Miguel Ventura ◽  
João Cristóvão ◽  
...  
Keyword(s):  
Cardiac Resynchronization Therapy ◽  
Progenitor Cells ◽  
Endothelial Progenitor Cells ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Endothelial Progenitor ◽  
Circulating Endothelial Progenitor Cells ◽  
The Impact

Abstract Background Recent studies suggest that circulating endothelial progenitor cells (EPCs) may influence the response to cardiac resynchronization therapy (CRT). The aim of this study was to evaluate the effect of CRT on EPCs levels and to assess the impact of EPCs on long-term clinical outcomes. Population and methods Prospective study of 50 patients submitted to CRT. Two populations of circulating EPCs were quantified previously to CRT implantation: CD34 + KDR + and CD133 + KDR + cells. EPCs levels were reassessed 6 months after CRT. Endpoints during the long-term follow-up were all-cause mortality, heart transplantation and hospitalization for heart failure (HF) management. Results The proportion of non-responders to CRT was 42% and tended to be higher in patients with an ischemic vs non-ischemic etiology (64% vs 35%, p=0.098). Patients with ischemic cardiomyopathy (ICM) showed significantly lower CD34+KDR+ EPCs levels when compared to non-ischemic dilated cardiomyopathy patients (DCM) (0.0010 ± 0.0007 vs 0.0030 ± 0.0024 cells/100 leukocytes, p=0.032). There were no significant differences in baseline EPCs levels between survivors and non-survivors nor between patients who were rehospitalized for HF management during follow-up or not. At 6-month follow-up, circulating EPCs levels were significantly higher than baseline levels (0.0024 ± 0.0023 vs 0.0047 ± 0.0041 CD34 + KDR + cells/100 leukocytes, p=0.010 and 0.0007 ± 0.0004 vs 0.0016 vs 0.0013 CD133 + /KDR + cells/100 leukocytes, p=0.007). Conclusions Patients with ICM showed significantly lower levels of circulating EPCs when compared to their counterparts. CRT seems to improve the pool of endogenously circulating EPCs and reduced baseline EPCs levels seem not influence long-term outcomes after CRT.

The distribution of ICD therapy by extent of response to cardiac resynchronization therapy; results of long term clinical follow up

2013 ◽  
Vol 34 (suppl 1) ◽  
pp. P3161-P3161
Author(s):  
A. C. Van Der Heijden ◽  
U. Hoke ◽  
C. J. W. Borleffs ◽  
J. Thijssen ◽  
J. B. Van Rees ◽  
...  
Keyword(s):  
Cardiac Resynchronization Therapy ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Icd Therapy

Abstract 5998: Final Results of the HEALING 2B Trial to Evaluate a Bioengineered CD34 Antibody Coated Stent (Genous ™ Stent) Designed to Promote Vascular Healing by Capture of Circulating Endothelial Progenitor Cells in CAD Patients

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
H Duckers ◽  
Yoshinobu Onuma ◽  
Edouard Benit ◽  
Robert J de Winter ◽  
William Wijns ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Statin Therapy ◽  
Progenitor Cells ◽  
Endothelial Progenitor Cells ◽  
Stent Thrombosis ◽  
De Novo ◽  
Endothelial Progenitor ◽  
Circulating Endothelial Progenitor Cells ◽  
Late Luminal Loss

Background: In contrast to a cytotoxic or cytostatic pharmacotherapy, promoting the vascular healing response by capturing and sequestering circulating endothelial progenitor cells (EPC) to the stent surface by a CD34 antibody coating (Genous ™ stent) may accelerate stent reendo-thelialization and prevent restenosis formation, as well as stent thrombosis (ST) Methods: The HEALING IIB study was a multi-center, prospective trial designed to assess the safety and efficacy of the Genous ™ bio-engineered stent in conjunction with HmG CoA reductase inhibitors (statins) to stimulate EPC recruitment, in the treatment of patients with de novo coronary artery lesions (n=100 pts). The primary safety endpoint was major adverse cardiac events (MACE) at 30 days, whereas the primary efficacy endpoint was late luminal loss by QCA at 6 months follow-up. Results: At interim analysis of the first 45 patients that completed the 6-month angiographic follow-up, the composite MACE rate was 11.1%, whereas 6.6% clinically justified target lesion revascularizations were observed. 2 Patients died within the first 30 days after stent implantation due to angiographically verified stent thrombosis. Low circulating EPC titers were previously associated with a poor response to the EPC capture stent with TLR events and high late loss. Therefore, patients were pre-treated with Atorvastatin 80 mg qd prior to the PCI in order to augment EPC levels. Statin therapy stimulated the levels of committed EPCs by +294%, but failed to increase the titer of CD34+cells (+25%). Although statin pretreatment stimulated EPC levels, the angiographic outcome of the EPC capture stent was not improved in these patients: in-stent late luminal loss was 0.77±0.46 mm. We anticipate to complete analysis of the 6 month angiographic follow-up of all 100 patients by the time of the AHA2008. Conclusions: The HEALING-IIB study suggests that the EPC capture coronary stent in combination with statin therapy does not sufficiently impede stent restenosis formation for the treatment of de novo coronary artery disease. Although concomitant statin therapy was able to stimulate EPC recruitment, it failed to stimulate CD34+ stem cell levels and did not improve the angiographic outcome of the bioengineered EPC capture stent.

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