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CARDIOVASCULAR GENOMIC MEDICINE

Circulating Endothelial Cells in Cardiovascular Disease

Haemostasis, Thrombosis, and Vascular Biology Unit, University Department of Medicine, City Hospital, Birmingham, United Kingdom

Manuscript received December 13, 2005; revised manuscript received February 8, 2006, accepted February 14, 2006.

^_* Reprint requests and correspondence: Dr. Andrew D. Blann, University Department of Medicine City Hospital, Haemostasis, Thrombosis, and Vascular Biology, Dudley Road, Birmingham B18 7QH, United Kingdom (Email: a.blann{at}bham.ac.uk).

Quantification of circulating endothelial cells (CECs) in peripheral blood is developing as a novel and reproducible method of assessing endothelial damage/dysfunction. The CECs are thought to be mature cells that have detached from the intimal monolayer in response to endothelial injury and are a different cell population to endothelial progenitor cells (EPCs). The EPCs are nonleukocytes derived from the bone marrow that are believed to have proliferative potential and may be important in vascular regeneration. Currently accepted methods of CEC quantification include the use of immunomagnetic bead separation (with cell counting under fluorescence microscopy) and flow cytometry. Several recent studies have shown increased numbers of CECs in cardiovascular disease and its risk factors, such as unstable angina, acute myocardial infarction, stroke, diabetes mellitus, and critical limb ischemia, but no change in stable intermittent claudication, essential hypertension, or atrial fibrillation. Furthermore, CEC quantification at 48 h after acute myocardial infarction has been shown to be an accurate predictor of major adverse coronary events and death at both 1 month and 1 year. This article presents an overview of the pathophysiology of CECs in the setting of cardiovascular disease and a brief comparison with EPCs.

Abbreviations and Acronyms   AF = atrial fibrillation   CAD = coronary artery disease   CEC = circulating endothelial cell   CVD = cardiovascular disease   EPC = endothelial progenitor cell   FMD = flow-mediated dilatation   MI = myocardial infarction   PVD = peripheral vascular disease   VEGFR = vascular endothelial growth factor receptor   vWf = von Willebrand factor

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