Effects of structured home-based exercise training on circulating endothelial progenitor cells and endothelial function in patients with intermittent claudication

• Published in: Vascular medicine (London, England) Vol. 26; no. 6; pp. 633 - 640
• Main Authors: Pasqualini, Leonella, Bagaglia, Francesco, Ministrini, Stefano, Frangione, Maria Rosaria, Leli, Christian, Siepi, Donatella, Lombardini, Rita, Marini, Ettore, Naeimi Kararoudi, Meisam, Piratinskiy, Alexander, Pirro, Matteo
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.12.2021; Sage Publications Ltd
• Subjects: Cardiovascular diseases; Cells (biology); Endothelial Progenitor Cells; Endothelium, Vascular; Exercise; Exercise - physiology; Exercise Test; Fitness equipment; Fitness training programs; Humans; Intermittent claudication; Intermittent Claudication - diagnosis; Intermittent Claudication - therapy; Microparticles; Pain; Physical training; Progenitor cells; Stem cells; Time measurement; Treadmills; Walking; flow-mediated vasodilation; endothelial progenitor cells; peripheral artery disease (PAD); physical activity
• DOI: 10.1177/1358863X211020822
• ISSN: 1358-863X

Introduction: Exercise training improves walking capacity in patients with intermittent claudication (IC). Endothelial progenitor cells (EPCs), endothelial microparticles (EMPs), and endothelial dysfunction could play a role in this process. Methods: We measured EPCs and EMPs in a group of 60 patients with IC, and in a control group of 20 individuals without IC, before a treadmill test and 2, 24, and 48 hours after the test. Thirty patients with IC were randomly assigned to perform a 12-week home-based exercise training program. The EPC count, flow-mediated dilation (FMD) of the brachial artery, pain-free walking time (PFWT), and maximum walking time (MWT) were measured at the baseline and after the exercise training program. Results: In patients with IC, EMPs significantly increased 2 hours after the treadmill test, whereas EPCs significantly increased after 24 hours. Among the subjects assigned to complete the training program, we observed a significant increase in the number of EPCs after 12 weeks, as well as an improvement in FMD, PFWT, and MWT. A significant correlation between the variation of EPCs, FMD, and MWT was found. The increase of EPCs and FMD were independent determinants of the walking capacity improvement, without significant interaction. Conclusion: Our results suggest that EPCs mobilization contributes to the improvement of walking capacity in patients with IC undergoing structured physical training. A number of different, partly independent, mechanisms are involved in this process, and our results highlight the potential role of EMPs release and endothelial function improvement. ClinicalTrials.gov Identifier: NCT04302571