Endothelial progenitor cells mobilization after maximal exercise according to heart failure severity

doi:10.4330/wjc.v12.i11.526

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World Journal of Cardiology

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World J Cardiol. Nov 26, 2020; 12(11): 526-539
Published online Nov 26, 2020. doi: 10.4330/wjc.v12.i11.526

Table 1 Demographic characteristics and maximal cardiopulmonary exercise testing indices of patients with chronic heart failure of different severity based on peak oxygen uptake

Demographic characteristics	Group 1	Group 2
Patients, n	25	24
Gender, males/females	21/4	20/4
Age in yr¹	57 ± 10	55 ± 9
Height in cm¹	174 ± 11	175 ± 9
Weight in kg¹	92 ± 25	87 ± 21
NYHA stage, class II/III	16/9	18/6
EF, %¹	32 ± 9	32 ± 8
Type of CHF
Dilated cardiomyopathy, n (%)	7 (28)	5 (21)
Ischemic, n (%)	14 (56)	15 (63)
Other, i.e. valvulopathy, etc., n (%)	4 (16)	4 (17)
Medication
Diuretics, n (%)	19 (76)	13 (54)
ACE inhibitors, n (%)	11 (44)	13 (54)
ARBs, n (%)	5 (20)	2 (8)
β-Blockers, n (%)	25 (100)	23 (96)
Aldosterone antagonists, n (%)	19 (76)	18 (75)
Cardiopulmonary exercise testing parameters
Peak VO₂ in mL/kg/min¹	14.5 ± 2.5	21.8 ± 2.4^a
Predicted peak VO₂, %¹	52 ± 13	74 ± 11^a
VE/VCO2 slope¹	34 ± 5	33 ± 4
Peak WR in watts¹	75 ± 34	118 ± 34^a

Group 1: Peak VO₂ < 18.0 mL/kg/min, Group 2: Peak VO₂ ≥ 18.0 mL/kg/min.

¹Values are expressed as mean ± SD; Difference between the 2 severity groups for demographic characteristics and cardiopulmonary exercise testing parameters (^aP < 0.05). ACE: Angiotensin-converting-enzyme; ARB: Angiotensin II receptor blockers; CPET: Cardiopulmonary exercise testing; CHF: Chronic heart failure; EF: Ejection fraction; NYHA: New York Heart Association; VCO₂: Carbon dioxide output; VO₂: Oxygen uptake; WR: Work rate.

Table 2 Acute mobilization of endothelial cellular populations after a symptom-limited cardiopulmonary exercise testing of two different severity groups according to the median value of peak oxygen uptake

Endothelial cellular populations	Group 1 of n = 25, peak VO₂ < 18.0 mL/kg/min		Group 2 of n = 24, peak VO₂ ≥ 18.0 mL/kg/min		P value between groups
Endothelial cellular populations	Before CPET	After CPET	Before CPET	After CPET	P value between groups
CD34⁺/CD45^-/CD133⁺	60 (25-76)	90 (70-103)^e	42 (19-73)	90 (39-118)^e	0.329
CD34⁺/CD45^-/CD133⁺/VEGFR₂	1 (1-4)	5 (3-8)^e	2 (1-3)	6 (3-9)^e	0.075
CD34⁺/CD133⁺/VEGFR₂	13 (9-17)	13 (9-26)	10 (7-18)	14 (10-19)^b	0.257
CD34⁺/CD45^-/CD133^-	186 (141-361)	488 (247-658)^e	218 (158-247)	311 (254-569)^e	0.101
CD34⁺/CD45^-/CD133^-/VEGFR₂	2 (1-2)	3 (2-5)^e	1 (1-2)	4 (2-6)^e	0.471

Difference within each severity group.

^bP < 0.01.

^eP < 0.001. CPET: Cardiopulmonary exercise testing; VO₂: Oxygen uptake.

Table 3 Acute mobilization of endothelial cellular populations after a symptom-limited cardiopulmonary exercise testing of different severity groups according to the median value of ventilation/carbon dioxide output slope

Endothelial cellular populations	Group 1 of n = 27, VE/VCO₂ slope < 32.5		Group 2 of n = 22, VE/VCO₂ slope ≥ 32.5		P value between groups
Endothelial cellular populations	Before CPET	After CPET	Before CPET	After CPET	P value between groups
CD34⁺/CD45^-/CD133⁺	62 (41-81)	95 (81-118)^e	31 (18-66)	70 (33-99)^e	0.711
CD34⁺/CD45^-/CD133⁺/VEGFR₂	1 (1-3)	5 (3-8)^e	2 (1-4)	5 (3-8)^e	0.311
CD34⁺/CD133⁺/VEGFR₂	10 (7-16)	13 (10-18)	12 (8-18)	16 (9-29)^b	0.134
CD34⁺/CD45^-/CD133^-	222 (147-287)	419 (267-576)^e	198 (152-376)	382 (249-794)^e	0.540
CD34⁺/CD45^-/CD133^-/VEGFR₂	1 (1-2)	3 (2-5)^e	1 (1-2)	4 (3-6)^e	0.464

Differences within each severity group.

^bP < 0.01.

^eP < 0.001. CPET: Cardiopulmonary exercise testing.

Table 4 Acute mobilization of endothelial cellular populations after a symptom-limited cardiopulmonary exercise testing of two different severity groups according to reduced or mid-ranged ejection fraction

Endothelial cellular populations	Group 1 of n = 37, EF < 40%		Group 2 of n = 12, EF ≥ 40%		P value between groups
Endothelial cellular populations	Before CPET	After CPET	Before CPET	After CPET	P value between groups
CD34⁺/CD45^-/CD133⁺	42 (22-75)	90 (37-106)^e	63 (40-76)	90 (65-103)^b	0.888
CD34⁺/CD45^-/CD133⁺/VEGFR₂	2 (1-3)	5 (3-8)^e	2 (1-4)	8(4-8)^b	0.507
CD34⁺/CD133⁺/VEGFR₂	11 (7-17)	14 (10-23)^b	15 (9-20)	13 (9-22)	0.473
CD34⁺/CD45^-/CD133^-	200 (152-279)	427 (260-626)^e	227 (135-372)	336 (214-624)^b	0.702
CD34⁺/CD45^-/CD133^-/VEGFR₂	1 (1-2)	3 (2-6)^e	1 (1-2)	3 (2-5)^b	0.828

Differences within each severity group.

^bP < 0.01.

^eP < 0.001. CPET: Cardiopulmonary exercise testing; EF: Ejection fraction.

Citation: Kourek C, Karatzanos E, Psarra K, Georgiopoulos G, Delis D, Linardatou V, Gavrielatos G, Papadopoulos C, Nanas S, Dimopoulos S. Endothelial progenitor cells mobilization after maximal exercise according to heart failure severity. World J Cardiol 2020; 12(11): 526-539
URL: https://www.wjgnet.com/1949-8462/full/v12/i11/526.htm
DOI: https://dx.doi.org/10.4330/wjc.v12.i11.526