Decreased circulating endothelial progenitor cell levels in patients with heart failure with preserved ejection fraction

Chia Hung Chiang, Po Hsun Huang, Hsin Bang Leu, Chien Yi Hsu, Ko Fan Wang, Jaw Wen Chen, Shing Jong Lin

Research output: Contribution to journalArticlepeer-review

19 Citations (Scopus)


Objectives: The purpose of this study was to explore the relationship between endothelial progenitor cell (EPC) levels, heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF). Methods: A total of 44 HFpEF patients, 40 HFrEF patients and 69 age-, gender- and comorbidity-matched controls were enrolled after evaluating their clinical manifestations and echocardiography findings. Flow cytometry with quantification of three EPC markers in peripheral blood samples was used to assess the number of circulating EPCs. Results: HFpEF and HFrEF patients had significantly decreased circulating EPC levels compared to controls. Among heart failure patients, patients with New York Heart Association functional class (FC) IV had fewer circulating EPCs compared to those with FC II and FC III (p = 0.053). A simple linear regression analysis of data showed that high sensitivity C-reactive protein, left ventricular ejection fraction, left atrium diameter and the ratio of medial early filling to early diastolic mitral annular velocity all correlated with the EPC count. In multivariate Cox regression analyses, both HFpEF and HFrEF were found to be independent predictors of a decreased EPC number. Conclusions: HFpEF and HFrEF patients have decreased circulating EPC numbers, which is an indication of impaired endothelial turnover.

Original languageEnglish
Pages (from-to)191-201
Number of pages11
JournalCardiology (Switzerland)
Issue number3
Publication statusPublished - Oct 1 2013
Externally publishedYes


  • Endothelial progenitor cells
  • Heart failure
  • Heart failure with preserved ejection fraction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Pharmacology (medical)


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