Moderated Poster Session VI: Cardiac rehabilitation

Abstract

P316 Endothelial progenitor cells mobilization and inflammation after cardiac rehabilitation on patients undergoing percutaneous coronary intervention after acute coronary sindrome F Cesari, R Marcucci, F Sofi, C Burgisser, S Luly, R Abbate, GF Gensini, F Fattirolli Department of Medical and Surgical Critical Care, Thrombosis Centre, University of Florence, Florence, Italy, Cardiac Rehabilitation Center , Unit of Gerontology and Geriatrics , University of Florence, Florence, Italy Topic: Cardiovascular rehabilitation Background: Endothelial progenitor cells (EPCs) are bone marrow-derived progenitor cells which support vascular endothelium, so playing a crucial role in the beginning and progression of atherosclerosis. It has been previously demonstrated that a potent trigger for EPCs mobilization is regular physical exercise. However, few data regarding the possible effect of cardiac rehabilitation (CR) program after primary percutaneous coronary intervention (PCI) on EPCs are available. We performed this study in order to assess the variations of EPCs in relation to inflammatory markers in patients who performed a four weeks CR after PCI. Methods: 55 patients [45 M/10 F; mean age 58 (41-74) years] were admitted in an four weeks execise-based CR program after acute coronary syndrome and PCI. The numbers of EPCs and the sera levels of NT-ProBNP and high sensitivity C-reactive protein (CRP) were determined at the beginning (T1) and at the end (T2) of the CR program. All patients were under HMG-CoA reductase inhibitor therapy and performed a cardiopulmonary exercise test at T1 and at T2. Peripheral blood EPCs were measured by using flow cytometry and were defined as CD34þKDRþ, CD133þKDRþ and CD34þCD133þKDRþ. CRP and NT-ProBNP were measured by using a nephelometric and an immunometric method, respectively. Results: With regards to EPCs, we observed a significantly increase at T2 with respect to T1 [CD34þKDRþ: 7 (0-27) vs. 13 (0-37) cells/106 events p1⁄40.010; CD133þKDRþ: 7(0-27 vs. 10 (0-33) ) cells/106 events p1⁄40.018; CD34þCD133þKDRþ: 7 (0-27) vs. 10 (0-33) cells/106 events p1⁄40.014]. As expected, a significantly increase at T2 was observed for cardiopulmonary parameters (VO2max andWatt) whereas hsCRP andNT-ProBNP levels significantly decreased at T2 with respect to T1 values. By diving our patients populations in relation to the increase of EPCs, patients with an increase of EPCs were significantly younger with respect to the others [56 (42-74) vs. 61 (41-74) p<0.05], showed significantly lower baseline levels of CRP [2.5 (0.4-9.0) vs. 6.3 (0.3-9.1) mg/L p<0.05] and a better exercise tolerance with higher basal VO2max [21.0 (10.0-30.7) vs. 17.9 (10.0-28.0) ml/Kg/min]. Moreover, among cardiovascular risk factors the presence of smoking habit and obesity negatively influenced the increase of EPCs. Conclusion: A four weeks exercise-based CR program after ACS and PCI, is able to determine an increase of EPCs number with a contemporary decrease of CRP and NT-ProBNP. However a different behaviour for EPCs can be detected among patients with regard to age, obesity, smoking habit, CRP levels and exercise tolerance.