Universität zu Köln

Schier, R., El-Zein, R., Cortes, A., Liu, M., Collins, M., Rafat, N., Teschendorf, P., Wu, Hua-Kang, Heymach, J., Mehran, R. and Riedel, B. (2014). Endothelial progenitor cell mobilization by preoperative exercise: a bone marrow response associated with postoperative outcome. Br. J. Anaesth., 113 (4). S. 652 - 661. OXFORD: ELSEVIER SCI LTD. ISSN 1471-6771

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Abstract

Background. Preoperative anaemia is associated with increased morbidity in patients undergoing major surgery. Whether erythrocytes are the only bone-marrow-derived cell lineage that associates with increased surgical complications is unknown. This prospective observational trial studied the mobilization of endothelial progenitor cells (EPCs) in response to exercise in association with postoperative complications. Methods. After IRB approval, 60 subjects undergoing major thoracic surgery were exercised to exhaustion (peak. (V) over dot(O2)). Peripheral blood collected before and after peak exercise was quantified for EPC lineages by fluorescence-activated cell sorter analysis. Complication analysis was based on the Clavien-Dindo classification. Results. Exhaustive exercise increased EPC [CD45 - 133+34+ cells=150 (0.00-5230) to 220 (0.00-1270) cells mu l(-1); median change (range)=20 (24,180-860) cells mu l(-1); P=0.03] but not mature endothelial cell (EC) subpopulations. Pre-exercise levels [odds ratio (OR)=0.86, 95% confidence interval (CI): 0.37-2.00, P=0.72), change after exercise as a continuous variable (OR=0.95, 95% CI: 0.41-2.22, P=0.91) and a positive response after exercise (change >0 cells mu l(-1); OR=0.41, 95% CI: 0.13-1.28, P=0.12) were not statistically significantly associated with the incidence of postoperative complications. Post-hoc receiver operating characteristic curve analyses revealed that subjects with a CD45-133+34+ increase >= 60 cells mu l(-1) in response to exercise suffered fewer postoperative complications [86% sensitivity, 48% specificity and AUC=0.67 (95% CI: 0.52-0.81)]. Conclusions. Preoperative exercise induces EPC into the peripheral circulation. Subjects with a poor EPC response had a pre-existing propensity for postoperative complications. This warrants further research into the role of bone marrow function as a critical component to endothelial repair mechanisms.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Schier, R. UNSPECIFIED UNSPECIFIED UNSPECIFIED El-Zein, R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Cortes, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Liu, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Collins, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Rafat, N. UNSPECIFIED UNSPECIFIED UNSPECIFIED Teschendorf, P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wu, Hua-Kang UNSPECIFIED UNSPECIFIED UNSPECIFIED Heymach, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Mehran, R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Riedel, B. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-427234
DOI:	10.1093/bja/aeu135
Journal or Publication Title:	Br. J. Anaesth.
Volume:	113
Number:	4
Page Range:	S. 652 - 661
Date:	2014
Publisher:	ELSEVIER SCI LTD
Place of Publication:	OXFORD
ISSN:	1471-6771
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CORONARY-ARTERY-DISEASE; ACUTE LUNG INJURY; PHYSICAL-ACTIVITY; NITRIC-OXIDE; CARDIAC REHABILITATION; CARDIOVASCULAR RISK; TRAINING INCREASES; BLOOD; SURVIVAL; ORIGIN Multiple languages Anesthesiology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/42723