Published online before print February 26, 2004, doi: 10.1161/01.ATV.0000124104.23702.a0
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© 2004 American Heart Association, Inc.
Vascular Biology |
Increase of Circulating Endothelial Progenitor Cells in Patients with Coronary Artery Disease After Exercise-Induced Ischemia
From University Leipzig (V.A., K.L., S.E., M.S., S.G., G.S., R.H.), Heart Center Leipzig, Clinic of Cardiology, and Pediatric Cardiology (D.L., A.T.), Germany; and Institute of Clinical Immunology and Transfusion Medicine (F.E.) University Leipzig, Germany.
Correspondence to Dr Volker Adams, Universität Leipzig, Herzzentrum GmbH, Klinik für Innere Medizin/Kardiologie, Strümpellstrasse 39, D-04289 Leipzig, Germany. E-mail adav{at}medizin.uni-leipzig.de
Objectives— The concept of neovascularization in response to tissue ischemia has been extended by the finding of postnatal vasculogenesis initiated by endothelial progenitor cells (EPCs). The aim of this study was to analyze whether a maximal stress test in patients with coronary artery disease (CAD) increases the number of circulating EPCs.
Methods and Results— Blood concentration of EPCs was analyzed by FACS and cell culture assay in CAD patients with (n=16) or without (n=12) exercise-induced myocardial ischemia and in healthy subjects (n=11) for up to 144 hours after maximal stress test. Plasma concentrations of vascular endothelial growth factor (VEGF), basic fibroblast growth factor, tumor necrosis factor-
, and granulocyte macrophage-colony stimulating factor were determined by ELISA. EPCs increased significantly in ischemic patients, with a maximum after 24 to 48 hours (cell culture: 3.3±0.5-fold increase; FACS: 3.1±0.6-fold increase) and returned to baseline within 72 hour. In nonischemic patients and healthy subjects, no EPC increase was detectable. VEGF levels in ischemic patients increased significantly after 2 to 6 hours (maximum after 2 hours; 4.0±1.1-fold increase) and no change was observed in nonischemic patients and healthy subjects; 
VEGF and EPC correlated significantly (r=0.66).
Conclusions— Patients with symptomatic CAD respond to a single episode of exercise-induced myocardial ischemia with a time-dependent increase in circulating EPCs. This increase may be related to and preceded by an increase in plasma VEGF.
Key Words: exercise • growth factor • cytokines • endothelium
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