Document Detail


Intracoronary Transplantation of CD34(+) Cells is Associated with Improved Myocardial Perfusion in Patients with Non-ischemic Dilated Cardiomyopathy.
MedLine Citation:
PMID:  25459687     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: We investigated the effects of intracoronary transplantation of CD34(+) cells on myocardial perfusion in patients with non-ischemic dilated cardiomyopathy (DCM).
METHODS AND RESULTS: We enrolled 21 patients with DCM (LVEF <40%, NYHA class III) who underwent peripheral stem cell mobilization with G-CSF. CD34(+) cells were collected via apheresis. Patients underwent myocardial perfusion imaging and CD34(+) cells were injected in the coronary artery supplying viable segments with reduced myocardial perfusion and regional dysfunction. Myocardial perfusion imaging was repeated 6 months later. Clinical response to stem cell therapy was pre-defined as a change in LVEF >5%. The majority of patients were men (81%) with an age of 53±9 years, LVEF of 25±5%, and 6-minute walking distance of 354±71 m. Myocardial perfusion defects at rest were observed in 86% of patients and were more common in the LAD territory (50%). At 6 months follow-up, there was a significant improvement in rest myocardial perfusion scores (6.3±5.8 vs. 3.1±4.3, P<0.001), LVEF (25±7% vs. 29±8%, P=0.005), and 6-minute walking distance (354±71 m vs. 404±91 m, P<0.001). Responders to stem cell therapy had lower summed rest perfusion score (SPS) at both baseline (3.2±3.0 vs. 9.1±6.3, P=0.015) and follow-up (1.0±1.5 vs. 5.0±5.1, P=0.028).
CONCLUSIONS: CD34(+) cell transplantation may lead to improved myocardial perfusion in patients with non-ischemic DCM. Patients with less severe myocardial perfusion defects at baseline may have an increased likelihood to respond to intracoronary CD34(+) cell transplantation.
CLINICAL TRIAL REGISTRATION: www.clinicaltrials.gov: NCT01350310.
Authors:
Luka Lezaic; Aljaz Socan; Gregor Poglajen; Petra Kolenc Peitl; Matjaz Sever; Marko Cukjati; Peter Cernelc; Joseph C Wu; François Haddad; Bojan Vrtovec
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-11-18
Journal Detail:
Title:  Journal of cardiac failure     Volume:  -     ISSN:  1532-8414     ISO Abbreviation:  J. Card. Fail.     Publication Date:  2014 Nov 
Date Detail:
Created Date:  2014-12-2     Completed Date:  -     Revised Date:  2014-12-3    
Medline Journal Info:
Nlm Unique ID:  9442138     Medline TA:  J Card Fail     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 Elsevier Inc. All rights reserved.
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