Abstract 11986: Effects of Intracoronary Stem Cell Transplantation in Dilated Cardiomyopathy: 5-Year Follow-Up
Background: We investigated long-term clinical effects of intracoronary transplantation of CD34+ cells in patients with non-ischemic dilated cardiomyopathy (DCM).
Methods: Of 110 patients with DCM, 55 were randomized to CD34+ cell transplantation (SC group), and 55 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. 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 follow-up 27 (25%) patients died and 9 (8%) underwent heart transplantation. Of the 27 deaths, 13 were attributed to pump failure, and 14 were attributed to sudden cardiac death. Total mortality was lower in patients receiving SC therapy (8/55, 14%) than in Controls (19/55, 35%) (P= 0.01). The same was true of the pump failure (3/55 [5%] vs. 10/55 [18%], P =0.03), but not of the sudden cardiac death (5/55 [9%] vs. 9/55 [16%], P =0.39). SC therapy was the only independent predictor of outcome on multivariable analysis (P =0.04).
Conclusions: Intracoronary stem cell transplantation appears to be associated with improved ventricular remodeling, better exercise tolerance and improved long-term survival in patients with DCM.
- © 2011 by American Heart Association, Inc.