Abstract 11769: Intramyocardial Transthoracic Transplantation of Bone Marrow Mononuclear Cells for Non-Ischemic Dilated Cardiomyopathy is Not Associated with Improvement of Heart Function Evaluated by Cardiac Resonance Imaging
Background: In experimental models of dilated cardiomyopathy (DCM), bone marrow mononuclear cells (BMMC) transplantation improved heart function trough a paracrine regulation of citokyne production.
Hypothesis: Direct intramyocardial injection of BMMC in patients with DCM can improve left ventricular function assessed by cardiac magnetic resonance imaging (MRI) and physical capacity evaluated by six-minute walking test (6WT) and heart failure class (NYHA).
Methods: Thirty patients with symptomatic non-ischemic DCM and left ventricular ejection fraction (LVEF) <35%, despite optimized treatment, were randomized in a 1:2 proportion into 2 groups: control or treatment (BMMC). This received direct intramyocardial injection of 1.06±108 BMMC in 10 points of the left ventricular through a left lateral mini-thoracotomy. Controls received no intervention. Patients were followed for 12 months.
Results: BMMC group showed a trend toward improvement of LVEF after 3 months follow-up, from 27.80±6.86% to 30.13±9.06% (p=0.08). At 9 months, LVEF was similar to baseline (28.78%, p=0.77). Patients of control group maintained LEVF during follow-up (28.00±4.32%; 27.42±7.41% and 29.57±4.50%, respectively). Differences between groups were not statistically significant. BMMC group had a significant improvement of NYHA class, from grade 3.40±0.50 to 2.41±0.79 (p=0.002); while control had a non significant decrease (from 3.37±0.51 to 2.71±0.95; p=0.17). Six minute walk test results showed a non-significant improvement in BMMC group (348.00±93.51m in baseline to 370.41±91.56m after 12 months, p = 0.66). Patients from control group had a non-significant decline (361.25±90.78m in baseline to 330.00±123.42m after 12 months, p = 0.66). Differences between groups were non significant for all variables studied.
Conclusions: Direct intramyocardial application of BMMC in DCM was not associate with significant changes in left ventricular function. Functional capacity did not differ between groups and differences observed in BMMC group could be due to placebo effect.
- © 2011 by American Heart Association, Inc.