The study on extracorporeal cardiac shock wave therapy inducing EPCs proliferation and stimulating ischemic myocardial angiogenesis

Purpose To investigate the changes of EPCs proliferation and related factors in peripheral blood after the CSWT treatment. Methods A total of 26 CAD patients undergoing extracorporeal cardiac shock wave therapy were selected. Mononuclear cells obtained from peripheral blood were cultured in EGM-2-MV medium. Cell morphology and the number of colonies formed were observed and analysed. After 7 days of culture, adherent cells were analysed and counted. Whether EPCs differentiated or not was identified by laser confocal microscopy; the number of circulating EPCs were studied by flow cytometry; the plasma level of VEGF, IL-8, SDF-1 and MMP-9 was determined by enzyme linked immunosorbent assay. Results The cultured EPCs and EPC-CFU number in vitro were significantly increase after therapy (EPCs (18.85±4.30) cell/high power field vs (30.12±6.77) cell/high power field (5.08±1.79) cell/high power field vs (12.27±2.75) cell/high power field, all p 0.05), compared with the group before treatment. Conclusions The CSWT appears to promote the expression of VEGF and IL-8 proteins, also stimulates the EPCs proliferation, significantly increases the EPCs and improves its function in peripheral blood, whereas the CSWT likes not influence so obviously on the expression of SDF-1, MMP-9.