J Anesth Perioper Med. 2014;1(1):15-24. https://doi.org/10.24015/ebcmed.japm.2014.0004
From the 1Department of Anesthesiology and Translational Neuroscience Center, 2Laboratory of Stem Cell Biology, State Key Laboratory of Biotherapy, 3Key Laboratory of Transplant Engineering and Immunology, 4Department of Lab Medicine, West China Hospital, Sichuan University, Chengdu, China; 5Respiratory, Critical Care and Sleep Disorders Medicine, Department of Medicine, University of Louisville, Louisville, USA; 6Department of Cardiothoracic Surgery, 7Regenerative Medicine Research Center, West China Hospital, Sichuan University, Chengdu, China.
*Contributed equally to the paper.
Correspondence to Dr. Jin Liu at scujinliu@foxmail.com.
EBCMED ID: ebcmed.japm.2014.0004 DOI: 10.24015/ebcmed.japm.2014.0004
Background
Endothelial progenitor cells (EPCs) play an important role in tissue repair, however, their role in reducing complications of cardiac surgery is unclear. This study evaluated the effect of EPCs on cardiac surgery outcomes.
Methods
The prospective, cohort, single central study was conducted in 127 rheumatic heart patients who received valve replacement with cardiopulmonary bypass from June 2009 to June 2011. Circulating EPCs were evaluated perioperatively. Composite surgical outcome was examined during hospital stays.
Results
EPC counts decreased from 42 cells/ml before surgery to 12 cells/ml 4 hours after surgery, although granulocyte colony- stimulating factor significantly increased. The incidence of death, acute respiratory distress syndrome (ARDS), acute renal dysfunction, heart failure occurred less in high EPC homing group (0% , 47.6% , 0% , 0%) than in medium (2.38%, 50%, 2.38%, 2.38%) and low (2.33%, 69.8%, 6.98%, 6.98% ) groups. Composite outcome events were also lower in high EPC homing group (P=0.000). Multivariate analysis showed the occurrence of composite outcome events and ARDS was still significantly different among the 3 groups (P=0.007 and P=0.042 respectively). Similarly, the higher pre-surgery EPC was associated with a lower incidence of composite outcome events (P=0.004).
Conclusions
EPC homing occurs during early stages after cardiac surgery, and may help to reduce complications.
Article Type
Original Article
Declaration of Interests
All authors have no financial support and potential conflicts of interest for this work.
Acknowledgements
This work was supported by grants (30872455, 81270324) from the National Natural Science Foundation of China and the project of National Basic Research Program of China (2009CB941200).
This is an open-access article, published by Evidence Based Communications (EBC). This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium or format for any lawful purpose. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.