Increased Number of Circulating Progenitor Cells After Implantation of Ventricular Assist Devices

Manginas, Athanassios; Tsiavou, Anastasia; Sfyrakis, Petros; Giamouzis, Gregory; Tsourelis, Loukas; Leontiadis, Evangelos; Degiannis, Dimitrios; Cokkinos, Dennis V.; Alivizatos, Petros A.

doi:10.1016/j.healun.2009.04.006

« Previous Next »The Journal of Heart and Lung Transplantation
Volume 28, Issue 7 , Pages 710-717, July 2009

Increased Number of Circulating Progenitor Cells After Implantation of Ventricular Assist Devices

Athanassios Manginas, MD
- Department of Cardiology, Onassis Cardiac Surgery Center, Athens, Greece
- Reprint requests: Athanassios Manginas, MD, FACC, FESC, Onassis Cardiac Surgery Center, Department of Cardiology, 356 Sygrou Ave, Kallithea, Athens, 176 74, Greece. Telephone: +30-210-949-3235. Fax: +30-210-949-3235
Anastasia Tsiavou, PhD
- Cardiothoracic Surgery & Heart Transplantation, Onassis Cardiac Surgery Center, Athens, Greece
Petros Sfyrakis, MD
- Molecular Immunopathology and Histocompatibility Laboratory, Onassis Cardiac Surgery Center, Athens, Greece
Gregory Giamouzis, MD
- Department of Cardiology, Onassis Cardiac Surgery Center, Athens, Greece
Loukas Tsourelis, MD
- Molecular Immunopathology and Histocompatibility Laboratory, Onassis Cardiac Surgery Center, Athens, Greece
Evangelos Leontiadis, MD
- Department of Cardiology, Onassis Cardiac Surgery Center, Athens, Greece
Dimitrios Degiannis, MD, PhD
- Cardiothoracic Surgery & Heart Transplantation, Onassis Cardiac Surgery Center, Athens, Greece
Dennis V. Cokkinos, MD
- Department of Cardiology, Onassis Cardiac Surgery Center, Athens, Greece
Petros A. Alivizatos, MD
- Molecular Immunopathology and Histocompatibility Laboratory, Onassis Cardiac Surgery Center, Athens, Greece

Received 28 November 2008; received in revised form 17 March 2009; accepted 7 April 2009. published online 15 May 2009.

Background

Bone marrow-derived circulating progenitor cells possess tissue repair potential, improving perfusion, left ventricular remodeling, and contractility in experimental models. We quantified and investigated the kinetics of 4 circulating progenitor cell sub-populations on the basis of CD34, CD133, and vascular endothelial growth factor receptor-2 (VEGFR-2) antigen expression.

Methods

CD34+, CD34+/CD133+/VEGFR-2–, CD34+/CD133+/VEGFR-2+, and CD34+/CD133–/VEGFR-2+ cells were counted in 10 male patients with end-stage congestive heart failure. Five underwent left ventricular/biventricular assist device (LVAD/BiVAD) implantation (VAD group), and 5 were ineligible for VAD implantation (no-VAD group). Peripheral blood was collected at 3 time points for each patient: before, 15, and 60 days after VAD placement in the VAD group and at the same time points in the no-VAD group. Purified CD34+ cells were stained with anti-CD34, anti-CD133, and anti-VEGFR-2 monoclonal antibodies and analyzed by flow cytometry. Serum levels of granulocyte-colony stimulating factor (G-CSF), interleukin-8, vascular endothelial growth factor-α (VEGF-α), and B-type natriuretic peptide (BNP) were also measured.

Results

In the VAD group the number of CD34+ cells/ml of blood tended to increase, from 159.6 ± 137.0 at baseline to 428.9 ± 224.3 at 15 days, and decreased to 343.8 ± 165.7 at 60 days (p = 0.05 vs no-VAD group). In the other 3 cell populations, no significant differences occurred over time or between groups. A significant interaction between BNP levels and VAD status was observed (p = 0.005): BNP levels decreased over time in VAD patients vs no-VAD patients. G-CSF levels tended to decrease over time in both groups, but without a significant difference (p = 0.3). Serum levels of interleukin-8 and VEGF-α over time or between VAD and no-VAD patients were not significantly different.

Conclusions

After VAD implantation, a transient increase occurs in the number of circulating CD34+ cells, in parallel to a reduction in BNP levels. Release of these cells from the bone marrow may contribute to the improvement of tissue perfusion and cardiac recovery occasionally seen after VAD placement.