Efficacy of Bone Marrow-Derived Stem Cells on Non-Ischemic Cardiomyopathy: A Systematic Review and Meta-Analysis of...

Background/Objectives: Non-ischemic cardiomyopathy (NICM) refers to myocardial disease characterized by structural and functional impairment without coronary artery disease. Stem cell therapy has emerged as a potential treatment to restore heart function in NICM, but clinical results have been inconsistent. Methods: This meta-analysis comprises five randomized controlled trials with a total of 302 patients, retrieved from PubMed, ScienceDirect, the Cochrane Library, and SAGE Journals. Results: Compared with the control group, stem cell therapy group showed significant improvements in the left ventricular ejection fraction (LVEF) at the 3-month follow-up (MD = 4.55, 95% CI 2.12-6.98, p = 0.0002), a reduction in the left ventricular end-diastolic diameter (LVEDD) at the 3-month follow-up (MD = -3.83, 95% CI -7.27 to -0.39, p = 0.03) and an improvement in the New York Heart Association (NYHA) functional class both at 3 months (MD = -0.58 95% CI -0.97 to -0.19, p = 0.004) and 12 months (MD = -0.49 95% CI -0.91 to -0.07, p = 0.02). Additionally, there was a significant decrease in the Minnesota Living with Heart Failure Questionnaire (MLHFQ) score at the 6-month follow-up (MD = -14.05, 95% CI -25.97 to -2.13, p = 0.021). However, no significant differences were observed in the left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), 6-min walk test (6-MWT), or major adverse cardiovascular events (MACEs) between the two groups. Conclusions: Bone marrow-derived stem cell therapy could be a promising and safe method to improve cardiac function and quality of life in patients with NICM. Further large-scale randomized controlled trials are needed to validate these findings.