Abstract
Background: Despite accumulating evidence regarding the occurrence of endothelial dysfunction in persistent atrial fibrillation (PAF) patients, little is still known about the number and function of circulating endothelial progenitor cells (EPCs) in PAF. Bepridil hydrochloride (BEP) is a multiple ion channel blocker that has exhibited efficacy for the pharmacological conversion of PAF. Methods and Results: We evaluated both the number and functional properties of CD34 + CD45 - cells as EPCs in 12 consecutive patients with PAF. The number of circulating EPCs was determined by flow cytometry. BEP was administered beginning at a daily dose of 100 mg and was increased up to a maximum of 200 mg for 30 days. Higher levels of circulating CD34 + CD45 - cells were observed in patients with PAF in comparison to the control subjects [ 0.35 +0.04% vs 0.14 + 0.03% CD34 + CD45 - cells in the MNC fraction, p<0.048]. However, the EPCs from patients with PAF exhibited an impaired migration towards SDF-1. Conclusion: The number of EPCs was observed to increase, but the EPC function was impaired in patients with persistent AF. BEP may have a beneficial effect on the pharmacological conversion of PAF by helping to restore the EPC function.
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