[Long-term results of intracoronary transplantation of autologous bone marrow cells in dilated cardiomyopathy].

Abstract

BACKGROUND:

Intracoronary delivery of autologous bone marrow mononuclear cells is an interesting therapeutic promise for patients with heart failure of different etiologies.

AIM:

To evaluate the long-term safety and efficacy of this therapy in patients with dilated cardiomyopathy of different etiologies under optimal medical treatment.

PATIENTS AND METHODS:

Prospective, open-label, controlled clinical trial. Of 23 consecutive patients, 12 were assigned to autologous bone marrow mononuclear cell intracoronary transplantation, receiving a mean dose of 8.19 ± 4.43 x 10(6) CD34+ cells. Mortality, cardiovascular readmissions and cancer incidence rate, changes in functional capacity, quality of life questionnaires and echocardiographic measures from baseline, were assessed at long-term follow-up (37.7 ± 9.7 months) in patients receiving or not the cells.

RESULTS:

No significant differences were observed in mortality, cardiovascular readmissions or cancer incidence rate amongst groups. An improvement in functional class and quality of life questionnaires in the transplanted group was observed (p < 0.01). The treated group showed a non-significant increase in left ventricular ejection fraction at long-term follow-up (from 26.75 ± 4.85% to 34.90 ± 8.57%, p = 0.059 compared to baseline). There were no changes in left ventricular volumes. We observed no improvement of these variables in the control group.

CONCLUSIONS:

Intracoronary transplantation of autologous bone marrow mononuclear cells is feasible and safe in patients with dilated cardiomyopathy of diverse etiologies. This therapy was associated to persistent improvements in functional class and quality of life. There was also a non-significant long-term improvement of left ventricular function.

• Authors: Jorge Bartolucci, Fernando J Verdugo, Flavio Carrion, Ema Abarzúa, Carlos Goset, Rubén Lamich, Patricio Sanhueza, Pablo Pedreros, Carolina Nazzal, Maroun Khoury, Fernando E Figueroa
• Journal: Revista medica de Chile (Rev Med Chil) Vol. 143 Issue 4 Pg. 415-23 (Apr 2015) ISSN: 0717-6163 [Electronic] Chile
• Vernacular Title: Resultados a largo plazo del trasplante intracoronario de células mononucleares de médula ósea autólogas en pacientes con cardiopatía dilatada de diversa etiología.
• PMID: 26204531 (Publication Type: Clinical Trial, Phase I, Clinical Trial, Phase II, Controlled Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Bone Marrow Transplantation (methods, mortality)
• Cardiac Volume (physiology)
• Cardiomyopathy, Dilated (diagnostic imaging, mortality, surgery)
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Patient Readmission (statistics & numerical data)
• Prospective Studies
• Quality of Life
• Stroke Volume (physiology)
• Surveys and Questionnaires
• Time Factors
• Transplantation, Autologous
• Treatment Outcome
• Ultrasonography
• Ventricular Function (physiology)