Unit:
Τομέας ΠαθολογίαςLibrary of the School of Health Sciences
Author:
Magkoutis Nikolaos
Dissertation committee:
Γεράσιµος Φιλιππάτος, Καθηγητής, Ιατρική, ΕΚΠΑ
Ευστάθιος Ηλιοδροµίτης, Καθηγητής, Ιατρική, ΕΚΠΑ
Ιωάννης Παρίσης, Αναπλ. Καθηγητής, Ιατρική, ΕΚΠΑ
Ιγνάτιος Οικονοµίδης, Αναπλ. Καθηγητής, Ιατρική, ΕΚΠΑ
Εριφύλη Χατζηαγγελάκη, Αναπλ. Καθηγήτρια, Ιατρική, ΕΚΠΑ
Περικλής Φούκας, Επικ. Καθηγητής, Ιατρική, ΕΚΠΑ
Χρήστος Κρούπης, Επικ. Καθηγητής, Ιατρική, ΕΚΠΑ
Original Title:
Χαμηλής συχνότητας νευρομυική ηλεκτρική διέγερση των σκελετικών μυών των κάτω άκρων & νεοαγγειογένεση σε ασθενείς με χρόνια καρδιακή ανεπάρκεια με χαμηλό κλάσμα εξώθησης
Translated title:
Effects of functional electrical stimulation of lower limb muscles on circulating endothelial progenitor cells, CD34+ cells and vascular endothelial growth factor-A in heart failure with reduced ejection fraction
Summary:
Background: Functional electrical stimulation (FES) of lower limb muscles, an alternative mode of exercise in patients not able or willing to train physically, is effective in improving clinical status and endothelial-dependent vasodilatation in heart failure (HF). We sought to evaluate the effects of FES on circulating levels of vascular endothelial growth factor-A (VEGF-A), endothelial progenitor cells (EPC) and CD34+ monocytes in HF with reduced LVEF (HFrEF).
Methods: We randomly assigned 27 HFrEF patients, aged 72 years, with NYHA class II/III symptoms to 6-week FES or sham procedure. We measured circulating levels of VEGF-A, EPC and CD34+ monocytes at baseline and after therapy along with clinical, functional and biochemical biomarkers.
Results: Baseline demographics, HF severity measures (NYHA class, LVEF, BNP, E/E’ ratio) and outcome variables (VEFG-A, CD34) did not differ between treatment groups, except for EPC that were lower in FES patients (p=0.003). FES induced a significantly higher increase in VEGF-A [∆-VEGF-A, 98.7 (21.6) in FES versus 3.1 (12.5) in sham, p=0.002] and a marginally significant increase in EPCs [∆-EPC, 5.3 of CD34+ (1.4) in FES versus 0.1 (0.8) in sham, p=0.092] and in CD34+ [∆-CD34, 2572.7cells/mL (1119.7) in FES versus -852.9 (1278.6), p=0.060]. FES further improved significantly NYHA class (p<0.001), 6-min walked distance (6MWD, p<0.001), BNP (p=0.014) and E/E’ ratio (p<0.001). ∆-VEGF-A and ∆-EPC correlated significantly with ∆-6MWD (rho=0.549, p=0.003 and rho=0.684, p<0.001, respectively) and ∆-CD34 both with ∆-6MWD (rho=0.648, p<0.001) and with ∆-E/E’ (rho=-0.597, p=0.001).
Conclusion: FES seems to induce VEGF-A expression and EPC and CD34+ cell mobilization in parallel to improving exercise capacity and central hemodynamics in HFrEF.
Main subject category:
Health Sciences
Keywords:
Functional electrical stimulation, Chronic heart failure, Angiogenesis
Number of references:
208
