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Intramyocardial Cell Delivery: Observations in Murine Hearts
Published on: January 24, 2014
Effects of intracoronary stem cell transplantation in patients with dilated cardiomyopathy
Bojan Vrtovec1, Gregor Poglajen, Matjaz Sever
1Advanced Heart Failure and Transplantation Center, Department of Cardiology, Ljubljana University Medical Center, Zaloska 7, Ljubljana, Slovenia. bojan.vrtovec@gmail.com
Insights
Intracoronary stem cell therapy improved cardiac function and exercise capacity in dilated cardiomyopathy patients. This stem cell transplantation also showed a trend toward improved survival rates in the study group.
Area of Science:
- Cardiology
- Regenerative Medicine
- Stem Cell Therapy
Background:
- Dilated cardiomyopathy (DCM) is a serious condition affecting heart muscle function.
- Investigating novel therapeutic strategies for DCM is crucial for improving patient outcomes.
Purpose of the Study:
- To evaluate the clinical efficacy of intracoronary transplantation of CD34+ stem cells in patients diagnosed with DCM.
- To assess the impact of stem cell therapy on cardiac function, exercise capacity, and survival.
Main Methods:
- A randomized controlled trial involving 55 DCM patients, with 28 receiving CD34+ stem cell therapy (SC group) and 27 serving as controls.
- Mobilization and collection of peripheral blood CD34+ cells via apheresis, followed by intracoronary injection into regions of myocardial ischemia.
- Assessment of clinical outcomes including left ventricular ejection fraction (LVEF), 6-minute walk distance, NT-proBNP levels, and mortality/heart transplantation rates at 1 year.
Main Results:
- Stem cell therapy significantly increased LVEF (25.5% to 30.1%, P=.03) and 6-minute walk distance (359m to 485m, P=.001).
- A significant reduction in NT-proBNP levels was observed in the SC group (2069 pg/mL to 1037 pg/mL, P=.01).
- The incidence of 1-year mortality or heart transplantation was significantly lower in the SC group (7% vs. 30%, P=.03), with SC therapy being an independent predictor of outcome.
Conclusions:
- Intracoronary CD34+ stem cell transplantation demonstrates potential for improving ventricular remodeling and exercise tolerance in DCM patients.
- The findings suggest a potential survival benefit associated with stem cell therapy in this patient population.
- Further research is warranted to confirm these promising results and optimize stem cell therapy protocols for DCM.
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.
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