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  • Effects of Intracoronary CD34+ Stem Cell Transplantation in Nonischemic Dilated Cardiomyopathy Patients
    Vrtovec, Bojan, 1972- ...
    Rationale: CD34+ transplantation in dilated cardiomyopathy was associated withshort-term improvement in left ventricular ejection fraction and exercise tolerance. Objective: We investigated long-term ... effects of intracoronary CD34+ cell transplantation in dilated cardiomyopathy and the relationship between intramyocardial cell homing and clinical response. Methods and Results: Of 110 dilated cardiomyopathy patients, 55 were randomized to receiveCD34+ stem cell transplantation (SC group) and 55 received no cell therapy (controls). In the SC group, CD34+ cells were mobilized by granulocytecolony-stimulating factor and collected via apheresis. Patients underwent myocardial scintigraphy and cells were injected in the artery supplying segments with the greatest perfusion defect. At baseline, 2 groups did not differ in age, sex, left ventricular ejection fraction, or N-terminal B-type natriuretic peptide levels. At 5 years, stem cell therapy was associated with increased left ventricular ejection fraction (from 24.3 Ž 6.5%to 30.0 Ž 5.1%; P=0.02), increased 6-minute walk distance (from 344 Ž 90 mto 477 Ž 130 m; P<0.001), and decreased N-terminal B-type natriuretic peptide(from 2322 Ž 1234 pg/mL to 1011 Ž 893 pg/mL; P<0.01). Left ventricular ejection fraction improvement was more significant in patients with higher myocardial homing of injected cells. During follow-up, 27 (25%) patients died and 9 (8%) underwent heart transplantation. Of the 27 deaths, 13 were attributed to pump failure and 14 were attributed to sudden cardiac death. Total mortality was lower in the SC group (14%) than in controls (35%; P=0.01). The same was true of pump failure (5% vs 18%; P=0.03), but not of sudden cardiac death (9% vs 16%; P=0.39). Conclusions: Intracoronary stem cell transplantation may be associated with improved ventricular function, exercise tolerance, and long-term survival in patients with dilated cardiomyopathy. Higher intramyocardial homing is associated with better stem cell therapy response.
    Source: Circulation research. - ISSN 0009-7330 (no. 1, Vol. 112, 4. jan. 2013, str. 165-173)
    Type of material - article, component part
    Publish date - 2013
    Language - english
    COBISS.SI-ID - 883628

    Link(s):

    http://circres.ahajournals.org/content/112/1/165.long
    DOI

source: Circulation research. - ISSN 0009-7330 (no. 1, Vol. 112, 4. jan. 2013, str. 165-173)
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