Purpose: Endothelial progenitor cells (EPCs) consist a cell population that enters the bloodstream from the bone marrow during tissue hypoxia and contributes to angiogenesis. Aerobic exercise induces tissue hypoxia and stimulates the mobilization of progenitor cells facilitating the endothelial function and contributing to the treatment of cardiovascular disease. The aim of this study was to investigate the effect of an aerobic exercise protocol on EPC mobilization and microcirculation in patients with chronic heart failure (CHF) compared to healthy individuals.

Materials and Methods: Patients that participated in the study were referred from the Heart Failure Clinic of the Cardiology Department of “Evangelismos” Hospital. Blood samples were collected before exercise, immediately after exercise, and 40 minutes post-exercise to determine the number of circulating EPCs and hematopoietic progenitor cells (HPCs) using flow cytometry. Changes in microcirculation were assessed using near-infrared spectroscopy before and after exercise.

Results: Sixteen patients (n = 16) with CHF and eleven healthy individuals (n = 11) participated in the study. The continuous aerobic exercise protocol revealed significant effects (p < 0.05) on the mobilization of EPCs and HPCs, as well as on endothelial function, in both patients with CHF and healthy individuals.

Conclusion: A single session of aerobic exercise can increase EPCs and HPCs and improve microcirculation in patients with chronic heart failure as well as in healthy individuals. Exercise performed using a low intensity, long-duration protocol stimulates physiological mechanisms that promote progenitor cell mobilization, microcirculatory function, and vascular regeneration.