Identification of pivotal factors potentially present in the in situ environment and capable of influencing the function of CD34(+) cells, which can be used for autologous cell therapy, is of paramount interest. SHh is one of the morphogens essential for embryonic vascular development as well as postnatal neovascularization, and the activation of SHh signaling with angiogenic and vascular differentiation responses in CD34(+) cells by SHh treatment differed depending on the G-CSF treatment or the background disease. SHh enhanced the migration, proliferation, adhesion, and EPC colony forming capacities of G-CSF mobilized CD34(+) cells, increasing the vasculogenic/angiogenic potential for neovascularization. An increase in the differentiation potential of CD34(+) cells toward vascular lineages was demonstrated with SHh treatment involving TGFβ signaling pathway. The SHh-activated G-CSF mobilized CD34(+) cells directly contributed to vascular regeneration while non-activated CD34(+) cells showed a lower regenerative capacity in a mouse ischemic hindlimb model. SHh signaling regulates human CD34(+) cell fate and function, and may potentiate the therapeutic effect of G-CSF mobilized CD34(+) cells on ischemic diseases.
Objective
This study aimed to investigate the effects of radiofrequency catheter ablation (
RFCA
) and clinical and electrophysiological characteristics in symptomatic patients with premature ventricular contractions (
PVC
s) from near the His‐bundle (His‐
PVC
s).
Methods
The patient characteristics, prevalence of complications with any life style related disease (
ALSRD
) including hypertension, dyslipidemia, or diabetes mellitus, and/or cardiovascular disease (
CVD
) including coronary artery disease, cerebrovascular disease, renal dysfunction, or cardiomyopathy, clinical status, frequency of
PVC
s evaluated by 24hour Holter monitoring, echocardiography including the left ventricular diastolic dysfunction (
LVDD
) parameters, and electrophysiological findings were evaluated in 14 consecutive symptomatic patients with His‐
PVC
s.
Results
The prevalence of males, being elderly and/or slightly obese, current and/or history of smoking,
ALSRD
or
CVD
related complications, and
LVDD
probably resulting from
ALSRD
and/or
CVD
complications were higher in patients with His‐
PVC
s.
RFCA
of His‐
PVC
s steadily decreased the
PVC
frequency and improved the systolic function,
LV
dilation, and clinical status, but not the
LVDD
. There was a significant relationship between the accordance rate of the
QRS
polarity between sinus rhythm and His‐
PVC
s and the distance between the successful ablation site and His‐bundle.
Conclusion
The analysis of the
QRS
duration and accordance rate of the
QRS
polarity between sinus rhythm and His‐
PVC
s before the
RFCA
may help to determine the distance between the origin of the
PVC
s and His‐bundle. Further, the appropriate ablation catheter may be selected during the
RFCA
procedure. Finally,
RFCA
may be one of the most effective, feasible, and safest therapies for symptomatic patients with His‐
PVC
s.
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