European Heart Journal Advance Access originally published online on March 29, 2007
European Heart Journal 2007 28(10):1258-1264; doi:10.1093/eurheartj/ehm011
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Circulation of CD34+ progenitor cell populations in patients with idiopathic dilated and ischaemic cardiomyopathy (DCM and ICM)
1 Medical Department I, Ludwig Maximilians University, Klinikum Grosshadern, Marchioninistr, 15, 81377 Munich, Germany
2 Institute of Medical Informatics, Biometry and Epidemiology (IBE), Ludwig Maximilians University, Klinikum Grosshadern, Munich, Germany
3 Department of Heart Surgery, Ludwig Maximilians University, Klinikum Grosshadern, Munich, Germany
Received 16 May 2006; revised 6 February 2007; accepted 15 February 2007; online publish-ahead-of-print 29 March 2007.
* Corresponding author. Tel: +49 89 7095 6095; fax: +49 89 7095 6094. E-mail address: wolfgang.franz{at}med.uni-muenchen.de
See page 1180 for the editorial comment on this article (doi:10.1093/eurheartj/ehm155)
Aims: This study aimed at analysing the endogenous stem cell circulation in patients suffering from idiopathic dilated cardiomyopathy (DCM) and ischaemic cardiomyopathy (ICM).
Methods and results: Cytokines in peripheral blood were analysed using enzyme-linked immunosorbent assay and circulating CD34+ stem cell populations (CD34+CD133+, CD34+CD31+, CD34+CXCR-4+) were measured by flow cytometry in DCM patients (n = 25), ICM patients (n = 15), and controls (n = 10). Explanted DCM (n = 5), ICM (n = 4) and normal hearts (n = 5) were analysed for the expression of several homing factors [stromal cell-derived factor-1 (SDF-1), Stem cell factor (SCF), HIF-1a, vascular cell adhesion molecule (VCAM), and Hepatocyte growth factor] by quantitative real-time polymerase chain reaction (PCR). SDF-1 was significantly elevated and positively correlated with brain natriuretic peptide (BNP) in peripheral blood of DCM and ICM patients showing the same New York heart association- (NYHA) class. In DCM patients circulating CD34+ cell populations were significantly increased in comparison to ICM patients and controls. mRNA of SDF-1, SCF, HIF-1a, and VCAM related to glyceraldehyde-3-phosphate dehydrogenase was significantly upregulated in ICM hearts when compared with DCM hearts and controls.
Conclusion: Myocardial homing factors are upregulated in ICM when compared with DCM hearts. Reduced homing of stem cells might therefore explain the increased number of CD34+ cells in DCM patients. These findings may open a new insight into the pathology and the treatment of idiopathic DCM.
Key Words: Dilated cardiomyopathy • Heart failure • Progenitor cell • Stem cell • Mobilization • Homing
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