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Circulating Endothelial Progenitor Cells and Clinical Outcome in Patients with Aortic Stenosis

BACKGROUND: Aortic stenosis (AS) is the most common valvular disease. Endothelial progenitor cells (EPCs) have a role in the repair of endothelial surfaces after injury. Reduced numbers of EPCs are associated with endothelial dysfunction and adverse clinical events, suggesting that endothelial injur...

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Autores principales: Shimoni, Sara, Bar, Iris, Meledin, Valery, Derazne, Estela, Gandelman, Gera, George, Jacob
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4767873/
https://www.ncbi.nlm.nih.gov/pubmed/26913741
http://dx.doi.org/10.1371/journal.pone.0148766
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author Shimoni, Sara
Bar, Iris
Meledin, Valery
Derazne, Estela
Gandelman, Gera
George, Jacob
author_facet Shimoni, Sara
Bar, Iris
Meledin, Valery
Derazne, Estela
Gandelman, Gera
George, Jacob
author_sort Shimoni, Sara
collection PubMed
description BACKGROUND: Aortic stenosis (AS) is the most common valvular disease. Endothelial progenitor cells (EPCs) have a role in the repair of endothelial surfaces after injury. Reduced numbers of EPCs are associated with endothelial dysfunction and adverse clinical events, suggesting that endothelial injury in the absence of sufficient repair by circulating EPCs promotes the progression of vascular and possibly valvular disorders. The aim of this study was to assess EPC number in patients with AS and to study the predictive value of their circulating levels on prognosis. METHODS: The number of EPCs was determined by flow cytometry in 241 patients with AS and a control group of 73 pts. Thirty-eight, 52 and 151 patients had mild, moderate and severe AS, respectively. We evaluated the association between baseline levels of EPCs and death from cardiovascular causes during follow up. RESULTS: EPC level was significantly higher in patients with AS compared to the control group (p = 0.017). Two hundred and three patients with moderate and severe AS were followed for a median of 20 months. One hundred and twenty patients underwent an intervention. Thirty four patients died during follow up, 20 patients died due to cardiac causes. Advanced age, the presence of coronary artery disease, AS severity index (combination of high NYHA class, smaller aortic valve area and elevated pulmonary artery pressure) and a low EPC number were predictors of cardiac death in the univariate analysis. Multivariate logistic regression model identified low EPCs number and AS severity index as associated with cardiac death during follow up (p = 0.026 and p = 0.037, respectively). CONCLUSIONS: EPC number is increased in patients with AS. However, in patients with moderate or severe AS a relatively low number of EPCs is associated with cardiac death at follow up. These results may help to identify AS patients at increased cardiovascular risk.
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spelling pubmed-47678732016-03-09 Circulating Endothelial Progenitor Cells and Clinical Outcome in Patients with Aortic Stenosis Shimoni, Sara Bar, Iris Meledin, Valery Derazne, Estela Gandelman, Gera George, Jacob PLoS One Research Article BACKGROUND: Aortic stenosis (AS) is the most common valvular disease. Endothelial progenitor cells (EPCs) have a role in the repair of endothelial surfaces after injury. Reduced numbers of EPCs are associated with endothelial dysfunction and adverse clinical events, suggesting that endothelial injury in the absence of sufficient repair by circulating EPCs promotes the progression of vascular and possibly valvular disorders. The aim of this study was to assess EPC number in patients with AS and to study the predictive value of their circulating levels on prognosis. METHODS: The number of EPCs was determined by flow cytometry in 241 patients with AS and a control group of 73 pts. Thirty-eight, 52 and 151 patients had mild, moderate and severe AS, respectively. We evaluated the association between baseline levels of EPCs and death from cardiovascular causes during follow up. RESULTS: EPC level was significantly higher in patients with AS compared to the control group (p = 0.017). Two hundred and three patients with moderate and severe AS were followed for a median of 20 months. One hundred and twenty patients underwent an intervention. Thirty four patients died during follow up, 20 patients died due to cardiac causes. Advanced age, the presence of coronary artery disease, AS severity index (combination of high NYHA class, smaller aortic valve area and elevated pulmonary artery pressure) and a low EPC number were predictors of cardiac death in the univariate analysis. Multivariate logistic regression model identified low EPCs number and AS severity index as associated with cardiac death during follow up (p = 0.026 and p = 0.037, respectively). CONCLUSIONS: EPC number is increased in patients with AS. However, in patients with moderate or severe AS a relatively low number of EPCs is associated with cardiac death at follow up. These results may help to identify AS patients at increased cardiovascular risk. Public Library of Science 2016-02-25 /pmc/articles/PMC4767873/ /pubmed/26913741 http://dx.doi.org/10.1371/journal.pone.0148766 Text en © 2016 Shimoni et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Shimoni, Sara
Bar, Iris
Meledin, Valery
Derazne, Estela
Gandelman, Gera
George, Jacob
Circulating Endothelial Progenitor Cells and Clinical Outcome in Patients with Aortic Stenosis
title Circulating Endothelial Progenitor Cells and Clinical Outcome in Patients with Aortic Stenosis
title_full Circulating Endothelial Progenitor Cells and Clinical Outcome in Patients with Aortic Stenosis
title_fullStr Circulating Endothelial Progenitor Cells and Clinical Outcome in Patients with Aortic Stenosis
title_full_unstemmed Circulating Endothelial Progenitor Cells and Clinical Outcome in Patients with Aortic Stenosis
title_short Circulating Endothelial Progenitor Cells and Clinical Outcome in Patients with Aortic Stenosis
title_sort circulating endothelial progenitor cells and clinical outcome in patients with aortic stenosis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4767873/
https://www.ncbi.nlm.nih.gov/pubmed/26913741
http://dx.doi.org/10.1371/journal.pone.0148766
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