Long-term effects of stem cell transplantation in heart failure
AbstractBackground: We investigated long-term effects of intracoronary transplantation of CD34+ cells in patients with dilated cardiomyopathy (DCM). Methods: Of 110 DCM patients, 55 were randomized to CD34+ cell transplantation (SC) group, and 55 patients received no cell therapy (controls). In the SC group, peripheral CD34+cells were mobilized by G-CSF and collected via apheresis. Patients underwent myocardial scintigraphy and CD34+ cells were injected in the artery supplying the segments with reduced viability. Patients were followed for 5 years. Results: At baseline, the 2 groups did not differ in age, gender, left ventricular ejection fraction (LVEF), or NT-proBNP levels. At 5 years, stem cell therapy was associated with an increase in LVEF (from 24.3 ± 6.5 % to 30.0 ± 5.1 %; P = 0.02), an increase in 6-minute walk distance (from 344 ± 90 m to 477 ± 130 m; P < 0.001), and a decrease in NT-proBNP (from 2322 ± 1234 pg/mL to 1011 ± 893 pg/mL; P < 0.01). During followup, 27 (25 %) patients died and 9 (8 %) underwent heart transplantation. Of the 27 deaths, 13 were attributed to pump failure, and 14 to sudden cardiac death. Total mortality was lower in SC group (8/55 [14 %]) than in controls (19/55 [35 %]) (P = 0.01). The same was true of pump failure (3/55 [5 %] vs. 10/55 [18 %], P = 0.03), but not of sudden cardiac death (5/55 [9 %] vs. 9/55 [16 %], P = 0.39). SC therapy was an independent predictor of outcome on multivariable analysis (P = 0.04). Conclusions: Intracoronary stem cell transplantation may be associated with improved ventricular remodeling, exercise tolerance, and longterm survival in patients with DCM.
The Author transfers to the Publisher (Zdravniški vestnik/Slovenian Medical Journal) all economic copyrights following form Article 22 of the Slovene Copyright and Related Rights Act (ZASP), including the right of reproduction, the right of distribution, the rental right, the right of public performance, the right of public transmission, the right of public communication by means of phonograms and videograms, the right of public presentation, the right of broadcasting, the right of rebroadcasting, the right of secondary broadcasting, the right of communication to the public, the right of transformation, the right of audiovisual adaptation and all other rights of the author according to ZASP.
The aforementioned rights are transferred non-exclusively, for an unlimited number of editions, for the term of the statutory
The Author can make use of his work himself or transfer subjective rights to others only after 3 months from date of first publishing in the journal Zdravniški vestnik/Slovenian Medical Journal.
The Publisher (Zdravniški vestnik/Slovenian Medical Journal) has the right to transfer the rights, acquired parties without explicit consent of the Author.
The Author consents that the Article be published under the Creative Commons BY-NC 4.0 (attribution-non-commercial) or comparable licence.