Growth Properties of Cardiac Stem Cells Are a Novel Biomarker of Patients’ Outcome After Coronary Bypass Surgery

Study Questions:

Does the growth reserve of cardiac stem cells (CSCs) and circulating cytokines promoting CSC activation impact ventricular remodeling in patients with coronary artery disease?

Methods:

The authors measured population-doubling time, telomere length, telomerase activity, and insulin-like growth factor-1 receptor expression in cardiac stem cells isolated from 38 patients undergoing coronary bypass surgery. The blood levels of insulin-like growth factor (IGF)-1, hepatocyte growth factor (HGF), and vascular endothelial growth factor were also evaluated. Echocardiography was used to assess cardiac function at baseline and 12 months after surgery.

Results:

There was a high correlation between indices of CSC function and cardiac anatomy. Negative ventricular remodeling was not observed if CSCs retained a significant growth reserve. A decline in CSC growth was associated with wall thinning, chamber dilation, and depressed ejection fraction. The levels of IGF-1 and HGF were, respectively, 2.5-fold and 27% higher before bypass surgery in patients who experienced positive left ventricular remodeling.

Conclusions:

The telomere-telomerase axis, population-doubling time, and insulin-like growth factor-1 receptor expression in CSCs, together with a high circulating level of insulin-like growth factor-1, represent a novel biomarker that can predict impact of revascularization on ischemic cardiomyopathy.

Perspective:

This is an interesting study that assesses the role of cardiac stem cell growth potential in patients with ischemic heart disease. The findings are provocative, but considerable future research will be needed to establish the clinical application of this approach.

Clinical Topics: Cardiac Surgery, Dyslipidemia, Heart Failure and Cardiomyopathies, Invasive Cardiovascular Angiography and Intervention, Noninvasive Imaging, Atherosclerotic Disease (CAD/PAD), Cardiac Surgery and Heart Failure, Lipid Metabolism, Heart Failure and Cardiac Biomarkers, Interventions and Coronary Artery Disease, Interventions and Imaging, Echocardiography/Ultrasound

Keywords: Somatomedins, Receptor, IGF Type 1, Coronary Artery Disease, Myocardial Ischemia, Demography, Stem Cells, Cytokines, Hepatocyte Growth Factor, Insulin-Like Growth Factor I, Biological Markers, Telomere, Vascular Endothelial Growth Factor A, Cardiomyopathies, Ventricular Remodeling, Telomerase, Coronary Artery Bypass, Echocardiography


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