Abstract 14838: Bone Marrow Stem-Cell Therapy for Idiopathic Dilated Cardiomyopathy
Bone marrow stem-cell therapy (BMSCT) has been used for functional recovery in patients (pts) with acute and chronic ischaemic heart disease. However, less information is available in pts with non-ischaemic dilated cardiomyiopathy (DC). This study prospectively analyzes the findings in a series of 27 pts with DC who were treated with BMSCT and followed-up for 1 year.
Methods: We studied pts with idiopathic DC in sinus rhythm with depressed left ventricular function and sympthoms of heart failure. Cells were aspirated from the iliac crest and mononuclear bone marrow cells (MNBMC) were prepared within 3 hours prior to intracoronary infusion. A total of 10.2±2.9x10e8 MNBMC were infused as follows: 50% in proximal left anterior descending artery, 25% in circumflex and 25% in right coronary artery. An in vitro biological study was conducted on a sample of the infused cells. Imunophenotype and migratory capacity were analyzed. Clinical and echocardiographic assessments were performed at baseline, after 3 month and after 1 year. Functional angiographic analysis following Sheehan's method was performed before treatment and at 6-month follow-up.
Results: Functional class improved at 1-year from 2.4±0.6 to 1.4±0.6 (p<0.001). The echocardiographic ejection fraction (EF) increased significantly at 3-month (28±7 vs 34±11%) and continued improving up to 1 year (38±12%; p<0.05). The angiographic EF also improved significantly at 6-month follow-up (28±9 vs 36±12%; p<0.001). The end-systolic volume decreased significantly (117±57 vs 95±44 ml/m²; p<0.01). The gain in EF significantly correlated with the number of CD133+ infused cells (r=-0.4; p<0.05). Mild mitral insufficiency was present in 10 pts at baseline study; at 6-month follow-up, it disappeared in 6 of them. Five pts showed no change in EF at 6-month evaluation (28±4 vs 23±5; ns) and were classified as non-responders. The remaining pts were considered responders with a significant gain in EF (13±7%). The responders were significantly younger (50±13 vs 63±9 years; p<0.05)
Conclusion: The intracoronary infusion of MNBMC in pts with idiopathic DC provides significant clinical and functional improvement at 6-month evaluation which is sustained 1 year after treatment.
- © 2011 by American Heart Association, Inc.