Relationship between circulating endothelial cells in and left ventricular diastolic dysfunction

Purpose: Stem and progenitor cells are implicated in ventricular remodelling and have great clinical significance in the pathophysiology of heart failure and atheromatosis. However, there are limited data regarding the involvement of endothelial cells (ECs) in the involvement of left ventricular diastolic dysfunction. The aim of this study is to investigate ECs circulation in patients with left ventricular (LV) diastolic dysfunction. Methods: We included 18 patients patients with symptoms and signs of heart failure who had an LVEF >50% and evidence of LV diastolic dysfunction (10 males, aged 54±10 years, and 10 healthy individuals (6 males, aged 54±10 years). All subjects underwent a complete echocardiographic study. In addition, peripheral blood samples from all participants were immunostained with antibodies against the cell surface markers CD34, CD45, CD133. Using flow cytometry, we have measured ECs as a population of CD45-/CD34+/CD133+ cells. The resulting counts were translated into the % percentage of ECs in the total cell number of peripheral blood. Results: Patients with LV diastolic dysfunction were shown to have increased circulating CD45-/CD34+/CD133+ cells (0.03±0.01%), compared to normotensives (0.0001±0.003%), (p < 0.05). CD45-/CD34+/CD133+ cell population revealed a positive correlation with E/e' (r=0.44, p=0.002). Conclusions: Hypertensive patients with left ventricular diastolic dysfunction were shown to have increased circulating ECs compared to healthy individuals. Our findings contribute to the understanding of pathogenesis of diastolic heart failure and might offer a future therapeutic target.