{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T03:28:21Z","timestamp":1778124501353,"version":"3.51.4"},"reference-count":41,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2023,10,18]],"date-time":"2023-10-18T00:00:00Z","timestamp":1697587200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003447","name":"State Scholarships Foundation","doi-asserted-by":"publisher","award":["MIS-5000432"],"award-info":[{"award-number":["MIS-5000432"]}],"id":[{"id":"10.13039\/501100003447","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Special Account for Research Grants, National and Kapodistrian University of Athens","award":["MIS-5000432"],"award-info":[{"award-number":["MIS-5000432"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Endothelial dysfunction and inflammation are common pathophysiological characteristics of chronic heart failure (CHF). Endothelial progenitor cells (EPCs) are recognized as useful markers of vascular damage and endothelial repair. The aim of this study was to investigate the effects of a cardiac rehabilitation program on EPCs and inflammatory profile in CHF patients of different severity. Forty-four patients with stable CHF underwent a 36-session cardiac rehabilitation program. They were separated into two different subgroups each time, according to the median peak VO2, predicted peak VO2, VE\/VCO2 slope, and ejection fraction. EPCs, C-reactive protein (CRP), interleukin 6 (IL-6), interleukin 10 (IL-10), and vascular endothelial growth factor (VEGF) were measured. Flow cytometry was used for the quantification of EPCs. Mobilization of EPCs increased and the inflammatory profile improved within each severity group (p &lt; 0.05) after the cardiac rehabilitation program, but there were no statistically significant differences between groups (p &gt; 0.05). A 36-session cardiac rehabilitation program has similar beneficial effects on the mobilization of EPCs and on the inflammatory profile in patients with CHF of different severity.<\/jats:p>","DOI":"10.3390\/jcm12206592","type":"journal-article","created":{"date-parts":[[2023,10,18]],"date-time":"2023-10-18T10:36:56Z","timestamp":1697625416000},"page":"6592","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["The Effects of a Cardiac Rehabilitation Program on Endothelial Progenitor Cells and Inflammatory Profile in Patients with Chronic Heart Failure of Different Severity"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4348-2153","authenticated-orcid":false,"given":"Christos","family":"Kourek","sequence":"first","affiliation":[{"name":"Clinical Ergospirometry, Exercise & Rehabilitation Laboratory, 1st Critical Care Medicine Department, Evangelismos Hospital, National and Kapodistrian University of Athens, 10676 Athens, Greece"},{"name":"Department of Cardiology, 417 Army Share Fund Hospital of Athens (NIMTS), 11521 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5740-9670","authenticated-orcid":false,"given":"Alexandros","family":"Briasoulis","sequence":"additional","affiliation":[{"name":"Department of Clinical Therapeutics, Faculty of Medicine, Alexandra Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece"},{"name":"Division of Cardiovascular Medicine, Section of Heart Failure and Transplantation, University of Iowa Hospitals and Clinics, Iowa, IA 52242, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6735-4183","authenticated-orcid":false,"given":"Eleftherios","family":"Karatzanos","sequence":"additional","affiliation":[{"name":"Clinical Ergospirometry, Exercise & Rehabilitation Laboratory, 1st Critical Care Medicine Department, Evangelismos Hospital, National and Kapodistrian University of Athens, 10676 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Virginia","family":"Zouganeli","sequence":"additional","affiliation":[{"name":"Second Cardiology Department, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherina","family":"Psarra","sequence":"additional","affiliation":[{"name":"Immunology and Histocompatibility Department, Evangelismos Hospital, 10676 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Pratikaki","sequence":"additional","affiliation":[{"name":"Clinical Biochemistry Department, Evangelismos Hospital, 10676 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Androula","family":"Alevra-Prokopiou","sequence":"additional","affiliation":[{"name":"Clinical Biochemistry Department, Evangelismos Hospital, 10676 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7159-2478","authenticated-orcid":false,"given":"John","family":"Skoularigis","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital of Larissa, 41334 Larissa, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9439-3946","authenticated-orcid":false,"given":"Andrew","family":"Xanthopoulos","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital of Larissa, 41334 Larissa, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Serafim","family":"Nanas","sequence":"additional","affiliation":[{"name":"Clinical Ergospirometry, Exercise & Rehabilitation Laboratory, 1st Critical Care Medicine Department, Evangelismos Hospital, National and Kapodistrian University of Athens, 10676 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2199-3788","authenticated-orcid":false,"given":"Stavros","family":"Dimopoulos","sequence":"additional","affiliation":[{"name":"Clinical Ergospirometry, Exercise & Rehabilitation Laboratory, 1st Critical Care Medicine Department, Evangelismos Hospital, National and Kapodistrian University of Athens, 10676 Athens, Greece"},{"name":"Cardiac Surgery Intensive Care Unit, Onassis Cardiac Surgery Center, 17674 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,10,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1002\/ejhf.592","article-title":"2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC","volume":"18","author":"Ponikowski","year":"2016","journal-title":"Eur. J. Heart Fail."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Tsigkou, V., Oikonomou, E., Anastasiou, A., Lampsas, S., Zakynthinos, G.E., Kalogeras, K., Katsioupa, M., Kapsali, M., Kourampi, I., and Pesiridis, T. (2023). Molecular Mechanisms and Therapeutic Implications of Endothelial Dysfunction in Patients with Heart Failure. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms24054321"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e003989","DOI":"10.1161\/JAHA.116.003989","article-title":"Biomarker Profiles in Heart Failure Patients with Preserved and Reduced Ejection Fraction","volume":"6","author":"Tromp","year":"2017","journal-title":"J. Am. Heart Assoc."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1007\/s12265-018-9810-4","article-title":"Endothelial Progenitor Cells in Heart Failure: An Authentic Expectation for Potential Future Use and a Lack of Universal Definition","volume":"11","author":"Djohan","year":"2018","journal-title":"J. Cardiovasc. Transl. Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1538","DOI":"10.1016\/j.jacc.2006.02.078","article-title":"Circulating endothelial cells in cardiovascular disease","volume":"48","author":"Boos","year":"2006","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1016\/j.arcmed.2022.02.001","article-title":"Reduced Levels of Circulating Endothelial Cells and Endothelial Progenitor Cells in Patients with Heart Failure with Reduced Ejection Fraction","volume":"53","author":"Lopes","year":"2022","journal-title":"Arch. Med. Res."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Kourek, C., Briasoulis, A., Zouganeli, V., Karatzanos, E., Nanas, S., and Dimopoulos, S. (2022). Exercise Training Effects on Circulating Endothelial and Progenitor Cells in Heart Failure. J. Cardiovasc. Dev. Dis., 9.","DOI":"10.3390\/jcdd9070222"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.hjc.2020.03.007","article-title":"Endothelial progenitor cells mobilization after maximal exercise in patients with chronic heart failure","volume":"62","author":"Kourek","year":"2021","journal-title":"Hell. J. Cardiol."},{"key":"ref_9","first-page":"100702","article-title":"The acute and long-term effects of a cardiac rehabilitation program on endothelial progenitor cells in chronic heart failure patients: Comparing two different exercise training protocols","volume":"32","author":"Kourek","year":"2020","journal-title":"Int. J. Cardiol. Heart Vasc."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"526","DOI":"10.4330\/wjc.v12.i11.526","article-title":"Endothelial progenitor cells mobilization after maximal exercise according to heart failure severity","volume":"12","author":"Kourek","year":"2020","journal-title":"World J. Cardiol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"American Thoracic Society, and American College of Chest Physicians (2003). ATS\/ACCP Statement on cardiopulmonary exercise testing. Am. J. Respir. Crit. Care Med., 167, 211\u2013277.","DOI":"10.1164\/rccm.167.2.211"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"S49","DOI":"10.1164\/arrd.1984.129.2P2.S49","article-title":"Predicted values for clinical exercise testing","volume":"129","author":"Hansen","year":"1984","journal-title":"Am. Rev. Respir. Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1016\/j.ijcard.2005.10.032","article-title":"Early heart rate recovery after exercise predicts mortality in patients with chronic heart failure","volume":"110","author":"Nanas","year":"2006","journal-title":"Int. J. Cardiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"3086","DOI":"10.1161\/CIRCULATIONAHA.106.675041","article-title":"Superior cardiovascular effect of aerobic interval training versus moderate continuous training in heart failure patients: A randomized study","volume":"115","author":"Loennechen","year":"2007","journal-title":"Circulation"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1038\/nprot.2007.111","article-title":"A protocol for phenotypic detection and enumeration of circulating endothelial cells and circulating progenitor cells in human blood","volume":"2","author":"Duda","year":"2007","journal-title":"Nat. Protoc."},{"key":"ref_16","unstructured":"Biosciences, B. (2011). BD Cytometric Bead Array (CBA) Human Soluble Protein Master Buffer Kit Instruction Manual, Becton, Dickinson and Company BD Biosciences."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1006\/dbio.1995.1180","article-title":"Vascular endothelial growth factor (VEGF) and VEGF receptor 2 (flk-1) are expressed during vasculogenesis and vascular differentiation in the quail embryo","volume":"169","author":"Flamme","year":"1995","journal-title":"Dev. Biol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1161\/CIRCHEARTFAILURE.109.868992","article-title":"Exercise training in patients with advanced chronic heart failure (NYHA IIIb) promotes restoration of peripheral vasomotor function, induction of endogenous regeneration, and improvement of left ventricular function","volume":"3","author":"Erbs","year":"2010","journal-title":"Circ. Heart Fail."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1177\/2047487315588391","article-title":"Chronic heart failure and aging\u2014Effects of exercise training on endothelial function and mechanisms of endothelial regeneration: Results from the Leipzig Exercise Intervention in Chronic heart failure and Aging (LEICA) study","volume":"23","author":"Sandri","year":"2016","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1007\/s00392-016-0966-0","article-title":"Influence of exercise training on proangiogenic TIE-2 monocytes and circulating angiogenic cells in patients with peripheral arterial disease","volume":"105","author":"Dopheide","year":"2016","journal-title":"Clin. Res. Cardiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"418","DOI":"10.3109\/1354750X.2013.805342","article-title":"Aerobic training and angiogenesis activation in patients with stable chronic heart failure: A preliminary report","volume":"18","author":"Eleuteri","year":"2013","journal-title":"Biomarkers"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"4273809","DOI":"10.1155\/2022\/4273809","article-title":"The Effects of High-Intensity Interval Training on Exercise Capacity and Prognosis in Heart Failure and Coronary Artery Disease: A Systematic Review and Meta-Analysis","volume":"2022","author":"Wang","year":"2022","journal-title":"Cardiovasc. Ther."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.1007\/s10741-023-10316-3","article-title":"High-intensity interval training versus moderate-intensity continuous training in patients with heart failure: A systematic review and meta-analysis","volume":"28","author":"Okamura","year":"2023","journal-title":"Heart Fail. Rev."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2375","DOI":"10.1007\/s00421-016-3490-z","article-title":"High-intensity Interval training enhances mobilization\/functionality of endothelial progenitor cells and depressed shedding of vascular endothelial cells undergoing hypoxia","volume":"116","author":"Tsai","year":"2016","journal-title":"Eur. J. Appl. Physiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1186\/s40798-023-00553-z","article-title":"Effects and Optimal Dose of Exercise on Endothelial Function in Patients with Heart Failure: A Systematic Review and Meta-Analysis","volume":"9","author":"Ribeiro","year":"2023","journal-title":"Sports Med. Open"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1428","DOI":"10.1161\/CIRCULATIONAHA.104.508465","article-title":"C-reactive protein in heart failure: Prognostic value and the effect of valsartan","volume":"112","author":"Anand","year":"2005","journal-title":"Circulation"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"965","DOI":"10.1002\/ejhf.1482","article-title":"The clinical significance of interleukin-6 in heart failure: Results from the BIOSTAT-CHF study","volume":"21","author":"Tromp","year":"2019","journal-title":"Eur. J. Heart Fail."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e018549","DOI":"10.1161\/JAHA.120.018549","article-title":"Interleukin 6 and Development of Heart Failure with Preserved Ejection Fraction in the General Population","volume":"10","author":"Chia","year":"2021","journal-title":"J. Am. Heart Assoc."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"2450202","DOI":"10.1155\/2017\/2450202","article-title":"Aerobic Training Intensity for Improved Endothelial Function in Heart Failure Patients: A Systematic Review and Meta-Analysis","volume":"2017","author":"Pearson","year":"2017","journal-title":"Cardiol. Res. Pract."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1016\/S0735-1097(03)00848-9","article-title":"Anti-inflammatory effects of exercise training in the skeletal muscle of patients with chronic heart failure","volume":"42","author":"Gielen","year":"2003","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1854","DOI":"10.1016\/j.ijcard.2012.04.157","article-title":"Impact of a cardiac rehabilitation program and inflammatory state on endothelial progenitor cells in acute coronary syndrome patients","volume":"167","author":"Cesari","year":"2013","journal-title":"Int. J. Cardiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"532620","DOI":"10.4061\/2011\/532620","article-title":"Effect of exercise training on interleukin-6, tumour necrosis factor alpha and functional capacity in heart failure","volume":"2011","author":"Smart","year":"2011","journal-title":"Cardiol. Res. Pract."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1016\/j.ijcard.2010.10.045","article-title":"Effects of a short-term exercise training on serum factors involved in ventricular remodelling in chronic heart failure patients","volume":"155","author":"Gatta","year":"2012","journal-title":"Int. J. Cardiol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1016\/j.cjco.2023.02.009","article-title":"Impacts of Exercise Interventions on Inflammatory Markers and Vascular Adhesion Molecules in Patients with Heart Failure: A Meta-analysis of RCTs","volume":"5","author":"Malandish","year":"2023","journal-title":"CJC Open"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"559220","DOI":"10.3389\/fphar.2020.559220","article-title":"Signaling via the Interleukin-10 Receptor Attenuates Cardiac Hypertrophy in Mice During Pressure Overload, but not Isoproterenol Infusion","volume":"11","author":"Stafford","year":"2020","journal-title":"Front. Pharmacol."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Sobti, R., and Ganju, A.K. (2022). Biomedical Translational Research, Springer.","DOI":"10.1007\/978-981-16-8845-4"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Collado-Mateo, D., Lav\u00edn-P\u00e9rez, A.M., Pe\u00f1acoba, C., Del Coso, J., Leyton-Rom\u00e1n, M., Luque-Casado, A., Gasque, P., Fern\u00e1ndez-Del-Olmo, M.\u00c1., and Amado-Alonso, D. (2021). Key Factors Associated with Adherence to Physical Exercise in Patients with Chronic Diseases and Older Adults: An Umbrella Review. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18042023"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1007\/s00395-010-0105-4","article-title":"Exercise training improves function of circulating angiogenic cells in patients with chronic heart failure","volume":"105","author":"Hoymans","year":"2010","journal-title":"Basic Res. Cardiol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"2189","DOI":"10.1016\/j.ijcard.2012.05.124","article-title":"Speeding of pulmonary VO2 on-kinetics by light-to-moderate-intensity aerobic exercise training in chronic heart failure: Clinical and pathophysiological correlates","volume":"167","author":"Mezzani","year":"2013","journal-title":"Int. J. Cardiol."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Chen, J., Gu, S., Song, Y., Ji, X., Zeng, W., Wang, X., Wang, Y., and Feng, Q. (2021). The impact of cardiomotor rehabilitation on endothelial function in elderly patients with chronic heart failure. BMC Cardiovasc. Disord., 21.","DOI":"10.1186\/s12872-021-02327-5"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/S1836-9553(13)70160-7","article-title":"Program-related factors are associated with adherence to group exercise interventions for the prevention of falls: A systematic review","volume":"59","author":"McPhate","year":"2013","journal-title":"J. Physiother."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/20\/6592\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:09:05Z","timestamp":1760130545000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/20\/6592"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,18]]},"references-count":41,"journal-issue":{"issue":"20","published-online":{"date-parts":[[2023,10]]}},"alternative-id":["jcm12206592"],"URL":"https:\/\/doi.org\/10.3390\/jcm12206592","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,18]]}}}