The Potential Role of Circulating Endothelial Cells and Endothelial Progenitor Cells in the Prediction of Left Ventricular Hypertrophy in Hypertensive Patients.

Magdalena Budzyń,Angelika Osińska,Mariusz Kaczmarek,Maciej Boruczkowski,Bogna Gryszczyńka,Maria Iskra,Magdalena Paulina Kasprzak,Alicja Bukowska,Beata Begier-Krasińska

doi:10.3389/fphys.2019.01005

Abstract

BackgroundThe main aim of present study is to evaluate the potential role of circulating endothelial cells (CECs) and endothelial progenitor cells (CEPCs) – representing specific markers of endothelial damage, in the prediction of left ventricular hypertrophy (LVH) in hypertensive patients categorized into two groups; mild (MH) and resistant hypertension (RH).Materials and MethodsThirty patients with MH and 28 subjects with RH were involved in the study. In both groups, patients were divided into an LVH and non-LVH group. The control group included 33 age and sex-matched normotensive volunteers. Physical examination, laboratory tests and echocardiography were conducted.ResultsIn both the MH and RH group, patients with as well as without LVH demonstrated a higher number of CECs and a lower ratio of CEPCs/CECs as compared to the healthy control. Multiple linear regression analysis showed a positive association of CEPCs with left ventricular mass (LVM) and left ventricular mass index (LVMI), independently of other confounders.ConclusionOur results suggest that endothelial injury observed as an elevated CECs number and its impaired regeneration, reflected by a lowered CEPCs/CECs ratio, precede LVH occurrence and may play a significant role in LVH development regardless of the clinical severity of hypertension. Moreover, independent correlation of CEPCs with echocardiographic (ECG) incidences of LVH suggests their potential use as a screening biomarker to stratify the risk of LVH development.

Highlights

Left ventricular hypertrophy is one of the most common forms of target organ damage (TOD) occurring in hypertensive patients, associated with an increased cardiovascular disease-related morbidity and mortality (Ruilope and Schmieder, 2008; Katholi and Couri, 2011; Okwuosa et al, 2014; Shenasa and Shenasa, 2017)
No significant difference was found between the resistant hypertension (RH) and mild hypertension (MH) group in terms of age, gender, body mass index (BMI) and glucose concentration (Table 2)
The RH group demonstrated a higher concentration of cholesterol, highly sensitive C-reactive protein (hsCRP), urea and an elevated value of systolic blood pressure (SBP) as well as diastolic blood pressure (DBP) compared to the MH group (Table 2)

Summary

Introduction

Left ventricular hypertrophy is one of the most common forms of TOD occurring in hypertensive patients, associated with an increased cardiovascular disease-related morbidity and mortality (Ruilope and Schmieder, 2008; Katholi and Couri, 2011; Okwuosa et al, 2014; Shenasa and Shenasa, 2017). Recent studies indicate that some other factors, including those connected with endothelial dysfunction and/or damage, may play a significant role in the development and maintenance of LVH (Yildiz et al, 2003; Sciacqua et al, 2006; Peng et al, 2014; Bartnicki et al, 2016). Recent studies suggest that high susceptibility of RH patients to left ventricular remodeling may be associated with their worse endothelial status (Figueiredo et al, 2012; Chang-Min et al, 2014). The main aim of present study is to evaluate the potential role of circulating endothelial cells (CECs) and endothelial progenitor cells (CEPCs) – representing specific markers of endothelial damage, in the prediction of left ventricular hypertrophy (LVH) in hypertensive patients categorized into two groups; mild (MH) and resistant hypertension (RH)

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