体外心脏震波治疗对缺血性心脏病患者外周血基质细胞衍生因子1表达及内皮祖细胞增殖的影响

目的 探讨缺血性心脏病(IHD)患者经体外心脏震波治疗(CSWT)后心功能改善与基质细胞衍生因子1(SDF-1)表达、内皮祖细胞(EPCs)增殖的相关性,进而揭示CSWT改善IHD患者心功能的机制.方法 前瞻性收集2018年4月至2019年12月在昆明医科大学第一附属医院诊治的IHD患者20例,行内科标准治疗及CSWT...

Effects of extracorporeal cardiac shock wave therapy on stromal cell-derived factor 1 expression and endothelial progenitor cells proliferation in peripheral blood of patients with ischemic heart disease

Objective To investigate the correlation between the improvement of cardiac function and the expression of stromal cell-derived factor 1(SDF-1)and the proliferation of endothelial progenitor cells(EPCs)in patients with ischemic heart disease(IHD)after extracorporeal cardiac shock wave therapy(CSWT),and to reveal the mechanism by which CSWT improves cardiac function in IHD patients.Methods Prospectively,20 patients with IHD in the First Affiliated Hospital of Kunming Medical University from April 2018 to December 2019 underwent standard medical treatment and CSWT,with 9 CSWTs completed within 1 month.Before treatment,left ventricular global longitudinal strain(GLS)and 99Tcm-myocardial perfusion imaging(MPI)with single photon emission computed tomography(SPECT)were performed.Patients were followed up at 1 and 6 months after treatment with GLS and MPI to evaluate local myocardial systolic function and blood flow perfusion,recording New York Heart Association(NYHA)cardiac function classification,Canadian Cardiovascular Society(CCS)angina classification,Seattle Angina Questionnaire(SAQ),Minnesota Living with Heart Failure Questionnaire(MLHFQ)scores,36-item Short-Form Health Status Survey(SF-36)scores,6 minute walk distance(6MWD)and nitroglycerin dosage,and observing SDF-1,and EPCs index changes,analyze the correlation between improvement of patients’cardiac function and SDF-1 and EPCs.Results Twenty patients with IHD received 9 sessions of CSWT in a total of 43 ischemic treatment segments and were hemodynamically stable without any adverse events.Compared with pre-treatment,NYHA cardiac function class,CCS angina class,MLHFQ score and nitrate dosage were reduced and SAQ score,SF-36 score and 6MWD were improved at 1 and 6 months after treatment(all P<0.05);absolute GLS values increased and local perfusion of MPI improved in the treated segments(all P<0.05);SDF-1 and EPCs indexes showed an increasing trend(both P<0.05).Correlation analysis showed that SDF-1 was negatively correlated with NYHA cardiac function class(r=-0.56,P=0.00),EPCs was negatively correlated with NYHA cardiac function class(r=-0.26,P=0.04),and SDF-1 was not correlated with EPCs(r=0.06,P=0.62).Conclusions CSWT could increase myocardial perfusion and improve cardiac function by promoting vascular endothelial cell proliferation in patients with IHD,and elevated SDF-1 and EPCs are positively correlated with the improvement of cardiac function.