Effects of intracoronary stem cell transplantation in patients with dilated cardiomyopathy.

Abstract

BACKGROUND:

We investigated clinical effects of intracoronary transplantation of CD34+ cells in patients with dilated cardiomyopathy (DCM).

METHODS:

Of 55 patients with DCM, 28 were randomized to CD34+ transplantation (SC group), and 27 patients did not receive stem cell therapy (controls). In the SC group, peripheral blood CD34+ cells were mobilized by granulocyte-colony stimulating factor and collected via apheresis. Patients underwent myocardial scintigraphy and CD34+ cells were injected in the coronary artery supplying the segments with reduced viability.

RESULTS:

At baseline, the 2 groups did not differ in age, gender, left ventricular ejection fraction (LVEF), or NT-proBNP levels. At 1 year, stem cell therapy was associated with an increase in LVEF (from 25.5 ± 7.5% to 30.1 ± 6.7%; P = .03), an increase in 6-minute walk distance (from 359 ± 104 m to 485 ± 127 m; P = .001), and a decrease in NT-proBNP (from 2069 ± 1996 pg/mL to 1037 ± 950 pg/mL; P = .01). The secondary endpoint of 1-year mortality or heart transplantation was lower in patients receiving SC therapy (2/28, 7%) than in controls (8/27, 30%) (P = .03), and SC therapy was the only independent predictor of outcome on multivariable analysis (P = .04).

CONCLUSIONS:

Intracoronary stem cell transplantation could lead to improved ventricular remodeling, better exercise tolerance and potentially improved survival in patients with DCM.

• Authors: Bojan Vrtovec, Gregor Poglajen, Matjaz Sever, Luka Lezaic, Dragoslav Domanovic, Peter Cernelc, François Haddad, Guillermo Torre-Amione
• Journal: Journal of cardiac failure (J Card Fail) Vol. 17 Issue 4 Pg. 272-81 (Apr 2011) ISSN: 1532-8414 [Electronic] United States
• PMID: 21440864 (Publication Type: Journal Article, Randomized Controlled Trial)
• Copyright: Copyright © 2011 Elsevier Inc. All rights reserved.

Topics

• Cardiomyopathy, Dilated (mortality, physiopathology, therapy)
• Exercise Tolerance
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Stem Cell Transplantation (methods)
• Stroke Volume
• Treatment Outcome