Decreased CD34+Cell Number is Correlated with Cardiac Dysfunction in Patients with Acute Exacerbation of COPD
Decreased CD34+Cell Number is Correlated with Cardiac Dysfunction in Patients with Acute Exacerbation of COPD
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DOI：
10.1016/j.hlc.2014.03.008
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发表时间：
2014-09-01
影响因子：
2.6
通讯作者：
Xie, Canmao
中科院分区：
文献类型：
--
作者：
Liu, Yangli;Liu, Xiaoran;Xie, Canmao
研究背景慢性阻塞性肺疾病急性加重期（AECOPD）与心血管疾病（CVD）的发生风险和目的相关。先前的研究表明，骨髓来源的多能祖细胞（CD 34+细胞）的减少可能导致血管修复能力降低，并可能有助于识别心血管风险增加的患者。然而，CD 34+细胞与AECOPD中CVD风险之间的关系仍不清楚。本研究的目的是评估CD 34+细胞计数及其与AECOPD患者典型不良心脏结局预测因子的关系。方法27例AECOPD患者（GOLD Ⅲ、Ⅳ期），26例稳定期COPD患者（GOLD Ⅲ、Ⅳ期），24例健康对照者作为研究对象。计数CD 34+细胞，测量N末端B型利钠肽原（NT-proBNP）、全身炎症标志物（高敏C反应蛋白，hsCRP）和动员标志物（基质金属蛋白酶-9，MMP-9）的血浆浓度。进行超声心动图评估心功能不全和肺动脉高压。结果与健康对照相比，AECOPD患者的CD 34+细胞计数显着下降（5.1 +/- 2.6 vs 9.4 +/- 3.6 x 10（3）/m1），尤其是在有急性加重病史的患者中。AECOPD患者CD 34+细胞计数与NT-proBNP水平、肺动脉收缩压（PASP）和静息心率呈负相关，与左心室射血分数（LVEF）呈正相关。在所有三组中，CD 34+细胞计数与hsCRP呈负相关。结论AECOPD患者外周血CD 34+细胞计数降低，并与心功能不全相关，可能是AECOPD患者心血管危险性增加的原因。
Background Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is associated with a higher risk of and Purpose cardiovascular disease (CVD). Previous studies have indicated that the reduction of bone marrow-derived multipotent progenitors (CD34+ cells) may lead to reduced vascular repair capacity and may help to identify patients that pose an increased cardiovascular risk. However, the relationship between CD34 + cells and CVD risk in AECOPD remains unclear. The aim of the present study was to assess CD34+ cell counts and their relationship with classical adverse cardiac outcome predictors in AECOPD. Methods For our study, 27 patients with AECOPD (GOLD stage III, IV), 26 with stable COPD (GOLD stage III, IV), and 24 healthy controls were enrolled. CD34+ cells were enumerated, and plasma concentrations of Nterminal pro-B-type natriuretic peptide (NT-proBNP), a systemic inflammation marker (high-sensitivity Creactive protein, hsCRP) and mobilisation marker (matrix metalloproteinase-9, MMP-9), were measured. Echocardiography was performed to evaluate cardiac dysfunction and pulmonary hypertension. Results Compared with healthy controls, AECOPD patients had a significantly decreased CD34+ cell count (5.1 +/- 2.6 versus 9.4 +/- 3.6 x 10(3)/m1), especially in patients with a prior history of acute exacerbation. For patients with AECOPD, the CD34+ cell count was inversely correlated with NT-proBNP levels, pulmonary artery systolic pressure (PASP) and resting heart rate, and positively correlated with left ventricular ejection fraction (LVEF). In all three groups, CD34+ cell count was negatively correlated with hsCRP. Conclusions The circulating CD34+ cell count was decreased and correlated with cardiac dysfunction in AECOPD patients, and thus may account for the increased cardiovascular risk in this population.