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CXCR4+ and FLK-1+ Identify Circulating Cells Associated with Improved Cardiac Function in Patients Following Myocardial Infarction

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Abstract

The biomarkers CXCR4/FLK-1 select cardiac progenitors from a stem cell pool in experimental models. However, the translational value of these cells in human ischemic heart disease is unknown. Here, flow-cytometry identified CD45−/CXCR4+/FLK-1+ cells in 30 individuals without ischemic heart disease and 33 first-time acute myocardial infarction (AMI) patients. AMI patients had higher CD45−/CXCR4+/FLK-1+ cell-load at 48-h and 3- and 6-months post-AMI (p = 0.003,0.04,0.04, respectively) than controls. Cardiovascular risk factors and left ventricular (LV) ejection fraction were not associated with cell-load. 2D-speckle-tracking strain echocardiography assessment of LV systolic function showed improvement in longitudinal strain and dyssynchrony during follow-up associated with longitudinal increases in and higher 48-h post-AMI CD45−/CXCR4+/FLK-1+ cell-load (r = −0.525, p = 0.025; r = −0.457, p = 0.029, respectively). In conclusion, CD45−/CXCR4+/FLK-1+ cells are present in adult human circulation, increased in AMI and associated with improved LV systolic function. Thus, CD45−/CXCR4+/FLK-1+ cells may provide a diagnostic tool to follow cardiac regenerative capacity and potentially serve as a prognostic marker in AMI.

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Acknowledgments

We gratefully acknowledge the technical contributions of Jay Hiddinga, Ph.D. and Lisa Nesbitt.

Funding

This work was supported in part by the Todd and Karen Wanek Program for Hypoplastic Left Heart Syndrome, Marriott Regenerative Medicine Award, and Mayo Clinic. It was also supported by CTSA Grant Number UL1 TR000135 and TL1 TR000137 from the National Center for Advancing Translational Science (NCATS).

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Authors and Affiliations

  1. Mayo Medical School, College of Medicine, Rochester, MN, USA

    Rahul Suresh

  2. Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN, USA

    Anca Chiriac, Andre Terzic & Timothy J. Nelson

  3. Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic, Rochester, MN, USA

    Kashish Goel, Hector R. Villarraga, Francisco Lopez-Jimenez, Randal J. Thomas & Andre Terzic

  4. Division of General Internal Medicine and Transplant Center, Department of Medicine, Mayo Clinic, Rochester, MN, USA

    Timothy J. Nelson

  5. Center for Regenerative Medicine, Mayo Clinic, Rochester, MN, USA

    Andre Terzic & Timothy J. Nelson

  6. Department of Physical Medicine and Rehabilitation, Mayo Clinic, 200 First Street SW, Rochester, 55905, MN, USA

    Carmen Perez-Terzic

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Correspondence to Carmen Perez-Terzic.

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Associate Editor Lorrie Kirshenbaum oversaw the review of this article.

Rahul Suresh and Anca Chiriac are co-first authors.

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Suresh, R., Chiriac, A., Goel, K. et al. CXCR4+ and FLK-1+ Identify Circulating Cells Associated with Improved Cardiac Function in Patients Following Myocardial Infarction. J. of Cardiovasc. Trans. Res. 6, 787–797 (2013). https://doi.org/10.1007/s12265-013-9502-z

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