Circulating Progenitor Cells and Coronary Collaterals in Chronic Total Occlusion

Overview

Journal Int J Cardiol

Publisher Elsevier

Specialty Cardiology & Vascular Diseases

Date 2024 Apr 27

PMID 38677332

Authors

Daniel A Gold

Pratik B Sandesara

Bryan Kindya

Matthew E Gold

Vardhmaan Jain

Nishant Vatsa

Shivang R Desai

Adithya Yadalam

Alexander Razavi

Malika Elhage Hassan

Yi-An Ko

Chang Liu

Ayman Alkhoder

Alireza Rahbar

Mohammad S Hossain

Edmund K Waller

Wissam A Jaber

William J Nicholson

Arshed A Quyyumi

Affiliations

Soon will be listed here.

Abstract

Background: The role of circulating progenitor cells (CPC) in collateral formation that occurs in the presence of chronic total occlusions (CTO) of a coronary artery is not well established. In stable patients with a CTO, we investigated whether CPC levels are associated with (a) collateral development and (b) ischemic burden, as measured by circulating high sensitivity troponin-I (hsTn-I) levels.

Methods: CPCs were enumerated by flow cytometry as CD45 blood mononuclear cells expressing CD34 and both CD34 and CD133 epitopes. The association between CPC counts and both Rentrop collateral grade (0, 1, 2, or 3) and hsTn-I levels were evaluated using multivariate regression analysis, after adjusting for demographic and clinical characteristics.

Results: In 89 patients (age 65.5, 72% male, 27% Black), a higher CPC count was positively associated with a higher Rentrop collateral grade; [CD34+ adjusted odds ratio (OR) 1.49 95% confidence interval (CI) (0.95, 2.34) P = 0.082] and [CD34+/CD133+ OR 1.57 95% CI (1.05, 2.36) P = 0.028]. Every doubling of CPC counts was also associated with lower hsTn-I levels [CD34+ β -0.35 95% CI (-0.49, -0.15) P = 0.002] and [CD34+/CD133+ β -0.27 95% CI (-0.43, -0.08) P = 0.009] after adjustment.

Conclusion: Individuals with higher CPC counts have greater collateral development and lower ischemic burden in the presence of a CTO.

References

Fefer P, Knudtson M, Cheema A, Galbraith P, Osherov A, Yalonetsky S . Current perspectives on coronary chronic total occlusions: the Canadian Multicenter Chronic Total Occlusions Registry. J Am Coll Cardiol. 2012; 59(11):991-7. DOI: 10.1016/j.jacc.2011.12.007. View

Vicencio J, Yellon D, Sivaraman V, Das D, Boi-Doku C, Arjun S . Plasma exosomes protect the myocardium from ischemia-reperfusion injury. J Am Coll Cardiol. 2015; 65(15):1525-36. DOI: 10.1016/j.jacc.2015.02.026. View

Sahoo S, Mathiyalagan P, Hajjar R . Pericardial Fluid Exosomes: A New Material to Treat Cardiovascular Disease. Mol Ther. 2017; 25(3):568-569. PMC: 5363198. DOI: 10.1016/j.ymthe.2017.02.002. View

Musialek P, Tekieli L, Kostkiewicz M, Majka M, Szot W, Walter Z . Randomized transcoronary delivery of CD34(+) cells with perfusion versus stop-flow method in patients with recent myocardial infarction: Early cardiac retention of ⁹⁹(m)Tc-labeled cells activity. J Nucl Cardiol. 2010; 18(1):104-16. PMC: 3032199. DOI: 10.1007/s12350-010-9326-z. View

Asahara T, Masuda H, Takahashi T, Kalka C, Pastore C, Silver M . Bone marrow origin of endothelial progenitor cells responsible for postnatal vasculogenesis in physiological and pathological neovascularization. Circ Res. 1999; 85(3):221-8. DOI: 10.1161/01.res.85.3.221. View

Choo G . Collateral Circulation in Chronic Total Occlusions – an interventional perspective. Curr Cardiol Rev. 2015; 11(4):277-284. PMC: 4774630. DOI: 10.2174/1573403X11666150909112548. View

Beltrami C, Besnier M, Shantikumar S, Shearn A, Rajakaruna C, Laftah A . Human Pericardial Fluid Contains Exosomes Enriched with Cardiovascular-Expressed MicroRNAs and Promotes Therapeutic Angiogenesis. Mol Ther. 2017; 25(3):679-693. PMC: 5363195. DOI: 10.1016/j.ymthe.2016.12.022. View

Rigato M, Avogaro A, Fadini G . Levels of Circulating Progenitor Cells, Cardiovascular Outcomes and Death: A Meta-Analysis of Prospective Observational Studies. Circ Res. 2016; 118(12):1930-9. DOI: 10.1161/CIRCRESAHA.116.308366. View

Henry T, Merz C, Wei J, Corban M, Quesada O, Joung S . Autologous CD34+ Stem Cell Therapy Increases Coronary Flow Reserve and Reduces Angina in Patients With Coronary Microvascular Dysfunction. Circ Cardiovasc Interv. 2022; 15(2):e010802. PMC: 8843403. DOI: 10.1161/CIRCINTERVENTIONS.121.010802. View

10.

Waller E, Olweus J, Lund-Johansen F, Huang S, Nguyen M, Guo G . The "common stem cell" hypothesis reevaluated: human fetal bone marrow contains separate populations of hematopoietic and stromal progenitors. Blood. 1995; 85(9):2422-35. View

11.

Ceradini D, Kulkarni A, Callaghan M, Tepper O, Bastidas N, Kleinman M . Progenitor cell trafficking is regulated by hypoxic gradients through HIF-1 induction of SDF-1. Nat Med. 2004; 10(8):858-64. DOI: 10.1038/nm1075. View

12.

Tahhan A, Hammadah M, Mohamed Kelli H, Kim J, Sandesara P, Alkhoder A . Circulating Progenitor Cells and Racial Differences. Circ Res. 2018; 123(4):467-476. PMC: 6202175. DOI: 10.1161/CIRCRESAHA.118.313282. View

13.

Fadini G, Mehta A, Dhindsa D, Bonora B, Sreejit G, Nagareddy P . Circulating stem cells and cardiovascular outcomes: from basic science to the clinic. Eur Heart J. 2020; 41(44):4271-4282. PMC: 7825095. DOI: 10.1093/eurheartj/ehz923. View

14.

Takahashi T, Kalka C, Masuda H, Chen D, Silver M, Kearney M . Ischemia- and cytokine-induced mobilization of bone marrow-derived endothelial progenitor cells for neovascularization. Nat Med. 1999; 5(4):434-8. DOI: 10.1038/7434. View

15.

Mheid I, Hayek S, Ko Y, Akbik F, Li Q, Ghasemzadeh N . Age and Human Regenerative Capacity Impact of Cardiovascular Risk Factors. Circ Res. 2016; 119(7):801-9. PMC: 5026592. DOI: 10.1161/CIRCRESAHA.116.308461. View

16.

Kawamoto A, Iwasaki H, Kusano K, Murayama T, Oyamada A, Silver M . CD34-positive cells exhibit increased potency and safety for therapeutic neovascularization after myocardial infarction compared with total mononuclear cells. Circulation. 2006; 114(20):2163-9. DOI: 10.1161/CIRCULATIONAHA.106.644518. View

17.

Dhindsa D, Desai S, Jin Q, Sandesara P, Mehta A, Liu C . Circulating progenitor cells and outcomes in patients with coronary artery disease. Int J Cardiol. 2022; 373:7-16. PMC: 9840693. DOI: 10.1016/j.ijcard.2022.11.047. View

18.

Tahhan A, Hammadah M, Raad M, Almuwaqqat Z, Alkhoder A, Sandesara P . Progenitor Cells and Clinical Outcomes in Patients With Acute Coronary Syndromes. Circ Res. 2018; 122(11):1565-1575. PMC: 5970041. DOI: 10.1161/CIRCRESAHA.118.312821. View

19.

Asahara T, Murohara T, Sullivan A, Silver M, van der Zee R, Li T . Isolation of putative progenitor endothelial cells for angiogenesis. Science. 1997; 275(5302):964-7. DOI: 10.1126/science.275.5302.964. View

20.

Mehta A, Meng Q, Li X, Desai S, DSouza M, Ho A . Vascular Regenerative Capacity and the Obesity Paradox in Coronary Artery Disease. Arterioscler Thromb Vasc Biol. 2021; 41(6):2097-2108. PMC: 8147702. DOI: 10.1161/ATVBAHA.120.315703. View