EFFECT OF REHABILITATION PROGRAM ON CIRCULATING ENDOTHELIAL PROGENITOR CELLS AND INFLAMMATION IN PATIENTS UNDERGOING CARDIAC SURGERY
Abstract number: P-S-411
Cesari1 F., Caporale2 R., Capalbo3 A., Marcucci1 R., Pucci3 N., Macchi4 C., Vannucci5 M., Caciolli6 S., Abbate1 R., Gensini7 G.
11Medical and Surgical Critical Care, Thrombosis Centre, University of Florence 22Central Laboratory, Azienda Ospedaliero-Universitaria Careggi 33Medical and Surgical Critical Care, Thrombosis Centre, Institute of Sports Medicine 44Don Carlo Gnocchi Foundation, Onlus IRCCS 55Unit of Cardiologic Rehabilitation, I.F.C.A. "Ulivella e Glicini" 66Heart and Vessels, Unit of Cardiac Surgery, Azienda Ospedaliero-Universitaria Careggi 77Medical and Surgical Critical Care, Thrombosis Centre, Don Carlo Gnocchi Foundation, Florence, Italy
How-to-cite Cesari F, Caporale R, Capalbo A, Marcucci R, Pucci N, Macchi C, Vannucci M, Caciolli S, Abbate R, Gensini G. EFFECT OF REHABILITATION PROGRAM ON CIRCULATING ENDOTHELIAL PROGENITOR CELLS AND INFLAMMATION IN PATIENTS UNDERGOING CARDIAC SURGERY. J Thromb Haemost 2007; 5 Supplement 2: P-S-411
Abstract
Introduction: Endothelial progenitor cells (EPCs) are bone marrow-derived progenitor cells which are involved in supporting vascular endothelium. It was previously demonstrated that regular physical exercise is a potent trigger for EPCs mobilization. However, no data are available on the possible effect of a rehabilitation program after cardiac surgery on EPCs in patients who underwent cardiac surgery.
Methods: We assessed the variations of EPCs in relation to inflammatory markers [Interleukin-6 (IL-6), Interleukin-8 (IL-8), Interleukin-10 (IL-10), Interleukin-1 receptor antagonist (IL1Ra), vascular endothelial growth factor (VEGF) and highly-sensitive C-reactive protein (hsCRP)] in 92 patients [56 M/36 F; 72.5 (47-88) yrs] performing a 15 day-rehabilitation program after cardiac surgery [38 coronary artery bypass (CABG) = group A, and 54 valve replacement = group B]. Numbers of EPCs and inflammatory markers were determined pre-surgery (T1), at the beginning (T2) and at the end (T3) of the rehabilitation program. Peripheral blood EPCs were measured by using flow cytometric and defined as CD34+KDR+, CD133+KDR+ and CD34+CD133+KDR+. Inflammatory cytokines were determined using a multiplex bead-based assay and hsCRP by nephelometric method.
Results: With regards to EPCs, we observed a decrease at T2 in both groups, while at T3 EPCs increased with respect to T2 [CD34+KDR+: 0.0030 (0-0.025)% vs 0.0035 (0 -0.080)%; CD133+KDR+: 0.0030 (0-0.014)% vs 0.0035 (0-0.0175)% p<0.01; CD34+CD133+KDR+: 0.0020 (0-0.0240)% vs 0.0025 (0-0.065)%]. As concerning inflammatory pattern, IL-6, IL-8, IL-10, VEGF, IL1Ra and hsCRP levels significantly increased at T2 and then decreased at T3 without reaching T1 values.
Conclusions: In conclusion a 15-day rehabilitation program after cardiac surgery is able to determine an increase in EPCs' number with the contemporary decrease of inflammatory markers. These results can suggest a mechanism of physical exercise in determining revascularization process after cardiac surgery.
