Changes in Circulating Progenitor Cells Are Associated with Functional Capacity in Heart Failure Patients: A Longitudinal Study

Abstract

Purpose Circulating progenitor cells (CPCs) are involved in the process of endothelial repair and are a prognostic factor in cardiovascular diseases. We aimed to evaluate the association between serial measurements of CPCs and functional capacity in heart failure (HF) patients. Methods and Materials We included 126 consecutive consenting ambulatory HF patients with reduced left ventricular ejection fraction (LVEF 2 ). We used mixed-effect models to analyze the independent association between CPCs and peak VO 2 . Results The mean age was 55±12 years; 29 (23%) patients were female. Forty (35%) patients had ischemic cardiomyopathy. During follow up, a decrease in CD34+VEGFR2+cells was independently associated with increased functional capacity; a 10-cell decrease in CD34+VEGFR2+cells was associated with an increase of 0.2 ml/kg/min in peak VO 2 (p 2 of 0.28 ml/kg/min (p=0.01), and in diabetics a decrease, rather than an increase in EO-CFUs, was associated with an increased peak VO 2 (p Conclusions Higher EO-CFU and lower circulating CD34+VEGFR2+cells are associated with improvements in functional capacity in non-diabetic HF patients. Improved vascular angiogenic capacity could be associated with better functional capacity in HF patients. In diabetics, lower EO-CFUs were associated with improved functional capacity suggesting a differential behaviour.