Author + information
We selected patients with acute myocardial infarction (AMI) after emergency percutaneous coronary intervention (PCI). To search the effects of enhanced external counter-pulsation (EECP) on the number and function of endothelial progenitor cells (EPCs) in peripheral blood of these patients. And also, the restoration of endothelial function after emergency PCI of AMI were detected.
36 AMI patients who have received emergent PCI were put into 2 groups at random. The control group (16 cases) received drug treatment following the guide. The EECP group (16 cases) received drug treatment and enhanced external counter-pulsation therapy, which was at least 12 hours per month. The peripheral blood of the patients was taken in the first week and the eighth week after PCI, we obtain mononuclear cells (MNCs) from peripheral blood though density gradient centrifugation, and then culture the cells in EGM-2 culture. We identify the cells by fluorescence in taking and cell surface markers. The cells were plated on fibronectin-coated culture dishes for 7 days. Adherent cells were collected and marked with FITC-UEA-I/acLDL-DiL. EPCs were characterized as double positive for FITC-UEA-I /acLDL-DiL, and then placed under the fluorescence microscope for counting. The functions of endothelial progenitor cells were measured, such as proliferation, differentiation, migration, and angiogenesis ability. We also detected key cytokines related to endothelial cell repair and function, such as vascular endothelial growth factor (VEGF), platelet derivation growth factor (PDGF), basic fibroblast growth factor (BFGF), nitric oxide synthase (eNOS), and endothelin (ET), by ELISA and immunofluorescence techniques.
There were no statistical differences of baseline clinical characteristics in the two groups. On the eighth week, the numbers of EPCs in peripheral blood of both groups were significantly increased than that of the first week after emergency PCI of AMI. There were significantly more EPCs colony numbers, better proliferation ability and adhesion abilities (P < 0.05). Meanwhile, compared with control group on the eighth week, EECP treatment increased the numbers of EPCs and cell colony, and significantly improved the abilities of proliferation, migration, and angiogenesis (P < 0.05). In addition, EECP treatment promoted expressions of VEGF, PDGF, BFGF, eNOS (P < 0.05), decreased the amount ET on the contrary (P < 0.05).
After emergency PCI of AMI, EECP therapy not only increased the number, improved functions of EPCs in peripheral blood but also enhanced the restoration of endothelial function. So, based on vascular biomechanics and remodeling of endothelial function, EECP therapy can increase blood flow shear stress, thus promote endogenous vascular endothelial repair mechanisms after emergency PCI of AMI.