Circulating CD34+KDR+ endothelial progenitor cells are reduced in chronic heart failure patients as a function of Type D personality
Résumé
Aims: The aim of this study was to assess whether EPC number/function might be an explanatory factor for the observed relation between Type D personality (a joint tendency toward negative affectivity and social inhibition) and poor cardiovascular prognosis. We also assessed whether the effect of a single exercise bout on EPC number/function is affected by Type D personality. Methods and results: Thirty-five sedentary men with chronic heart failure (CHF; left ventricular ejection fraction ≤ 45%) underwent cardio-pulmonary exercise testing (CPET) and personality assessment with the 14-item Type D Scale. CD34+/KDR+ cells were quantified by flow cytometry before and immediately after CPET. Migration of early EPC towards vascular endothelial growth factor and stromal cell-derived factor-1α was investigated. Type D (n=10) and non-Type D patients (n=25) were comparable with regards to demographics, disease severity and Framingham risk factor score. Circulating EPC numbers were reduced by 54% in Type D versus non-Type D patients (0.084 ± 0.055 vs. 0.183 ± 0.029, % of lymphocytes, P= 0.006). Exercise led to a 60% increase in EPC in Type D patients whereas the EPC number remained unchanged in the non-Type D group (P= 0.049). Baseline migratory capacity was related to disease severity but was not different comparing Type D and non-Type D patients. Exercise induced a highly significant enhancement of migratory capacity in both groups. Conclusions: Reduced EPC numbers might explain impaired cardiovascular outcome in Type D patients. The observed larger increase in circulating EPC in these patients suggests that acute exercise elicits a more pronounced stimulus for endothelial repair.
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