The effects of exercise stress testing on soluble E-selectin, von Willebrand factor, and circulating endothelial cells as indices of endothelial damage/dysfunction
The effects of exercise stress testing on soluble E-selectin, von Willebrand factor, and circulating endothelial cells as indices of endothelial damage/dysfunction
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DOI：
10.1080/07853890701652833
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发表时间：
2008-01-01
影响因子：
4.4
通讯作者：
Lip, Gregory Y. H.
中科院分区：
文献类型：
--
作者：
Boos, Christopher J.;Balakrishnan, Balu;Lip, Gregory Y. H.
背景资料。全血循环内皮细胞(CECs)的定量是一个日益公认的内皮损伤/功能障碍的指标。内皮细胞异常与冠状动脉疾病(CAD)的严重程度有关。在一组疑似冠心病患者的运动负荷试验(EST)中，我们评估了CEC与内皮功能障碍的其他标志物(von Willebrand因子(VWF)和可溶性E-选择素(SEsel))的关系。我们研究了一组来我们胸痛诊所就诊的有劳力性胸痛史的患者。在跑步机上进行EST，采用完整的Bruce锻炼方案。分别于运动前、运动后即刻和EST后30min采血检测CECs(免疫珠法)、vWF和sEsel(均为酶联免疫吸附试验)。我们研究了31名患者(84%为男性，平均年龄为58.4(9.8)岁)。在整个队列中，14名患者(45.2%)EST呈阳性。运动导致CECs、sEsel、vWF、白细胞(WBC)、心率、平均血压和收缩压较基线显著升高(均P<；0.05)。运动后即刻CECS的变化与Delta vWF(r=0.45；95%CI 0.11~0.69：P=0.0 1)、Delta vWF与Delta sEsel(r=0.41；0.0 5~0.7：P=0.0 2)、Delta vWF与Delta sEsel(r=0.55；0.2 5~0.76：P=0.001)呈显著正相关。绝对或增量CEC计数都不能预测运动负荷/功能能力，也不能预测EST阳性结果的存在。与基线水平相比，EST导致内皮标记物(CECs、vWF和sEsel)显著增加。CEC的增加与其他内皮标志物的增加相关，但与运动负荷/能力或EST阳性无关。
Background. The quantification of circulating endothelial cells (CECs) in whole blood is an increasingly recognized index of endothelial damage/dysfunction. Abnormal CECs have been linked to the severity of coronary artery disease (CAD).Objective. We assessed the relationship of CECs to other markers of endothelial dysfunction (von Willebrand factor (vWF) and soluble E-selectin (sEsel)) during exercise stress testing (EST) in a cohort of patients with suspected CAD.Methods. We studied a cohort of patients referred to our chest pain clinic with a history of exertional chest pain. Treadmill EST was performed, using a full Bruce exercise protocol. Blood for CECs (immunobead method), vWF and sEsel (both ELISA) were collected immediately before (pre-exercise), immediately following exercise, and at 30 minutes post-EST.Results. We studied 31 patients (84% male; mean (SD) age 58.4 (9.8) years). Of the entire cohort, 14 patients (45.2%) had a positive EST. Exercise led to significant increases in levels of CECs, sEsel, vWF, white blood cells (WBC), heart rate, mean and systolic blood pressure compared with base-line (all P < 0.05). There was a significant correlation between the change (A (immediate post-pre-exercise)) in CECs and Delta vWF (r=0.45; 95% CI 0.11-0.69: P=0.01) and Delta sEsel (r=0.41; 0.05-0.7: P=0.02), as well as between Delta vWF and Delta sEsel (r=0.55; 0.25-0.76: P=0.001). Neither absolute nor Delta CEC counts were predictive of exercise work-load/functional capacity, nor the presence of positive EST results.Conclusion. EST led to a significant increase in endothelial markers (CECs, vWF, and sEsel) compared with base-line levels. The rise in CECs correlated with the increases in other endothelial markers, but was not related to the either exercise workload/capacity or to the presence of a positive EST.