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). I...

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Published in:	Journal of cardiac failure 2011-04, Vol.17 (4), p.272-281
Main Authors:	Vrtovec, Bojan, MD, PhD, Poglajen, Gregor, MD, Sever, Matjaz, MD, Lezaic, Luka, MD, Domanovic, Dragoslav, MD, PhD, Cernelc, Peter, MD, PhD, Haddad, François, MD, Torre-Amione, Guillermo, MD, PhD
Format:	Article
Language:	eng
Subjects:	Cardiomyopathy Cardiomyopathy, Dilated - mortality Cardiomyopathy, Dilated - physiopathology Cardiomyopathy, Dilated - therapy Cardiovascular Exercise Tolerance Female Follow-Up Studies heart Failure Humans Male Middle Aged Stem Cell Transplantation - methods stem Cells Stroke Volume Treatment Outcome
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Summary:	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.
ISSN:	1071-9164 1532-8414