Abstract 19525: Number and Function of Endothelial Progenitor Cells in Patients with Chronic Heart Failure and Healthy Subjects - Is Exercise Training Equally Effective in the Elderly?
Background: A reduction in number and function of endothelial progenitor cells (EPCs) occurs in both physiologic aging and chronic heart failure (CHF). It has, however, never been assessed, if disease and aging have equally negative effects on EPC function and concentration or if beneficial effects of exercise training (ET) are diminished in old age.
Methods: We recruited 30 pts. <55 ys. (mean age 45±3 yrs.) and 30 patients >65 ys (mean age 68±4 yrs.) with stable CHF (EF 28.3±1.7%, VO2max 13.6±2.0ml/kg*min) and 30 healthy subjects (HS) <55 ys. (mean age 46±3) and 30 HS >65 ys (mean age 68±4) (EF 60±1%, VO2max 21.1±3.1 ml/kg*min) to a training (T) or a control group (C). Subjects in the T-group exercised 4 times daily at 60 to 70% of VO2max for 4 wks. under supervision. EPC number was quantified by FACS (CD34+/KDR+), EPC-function by SDF-1-Migration-Assay at baseline and at 4 weeks.
Results: At baseline old HS showed a reduced EPC-number (73.7±2.9 EPC/100ml blood versus 82.8±3.2 EPC/100ml blood in young; p<0.05) and function (212±21cells/1000 plated cells versus 287±24cells/1000plated cells; p<0.05). In young and old CHF pts., EPC-number (y: 57.2±3.9 EPC/100ml blood; o: 53.2±4.1 EPC/100ml blood) and EPC-function (y: 105±17cells/1000plated cells o: 121±23cells/1000plated cells) were impaired. Training improved EPC-function by 24% in old HS (p<0.05), while it remained unchanged in young training HS and C, respectively. The significant improvement in EPC-numbers and EPC-function did not differ between young and old patients with CHF (young: number +66% function +43%; p<0.05; old: number +69% function +36%; p=NS between training groups). In C no effects were detectable.
Conclusions: The present trial provides new insight into the chronobiology of vascular endothelial training effects: The age-dependent decrease in EPC number and function observed in HS is absent in CHF, where the negative disease effect is dominating. In elderly HS only functional EPC improvement was detected after ET. In CHF, on the contrary, both younger and older CHF pts. benefited equally from ET with an increase in EPC-number and EPC-function. This novel finding emphasizes the potentials of rehabilitation interventions in a the patient group with the highest CHF prevalence.
- © 2010 by American Heart Association, Inc.