Abstract 15298: Effects of Transendocardial CD34+ Cell Transplantation on Diastolic Parameters in Patients With Non-ischemic Dilated Cardiomyopathy
Introduction: The underlying mechanisms of CD34+ cell therapy in patients with non-ischemic dilated cardiomyopathy (DCM) are poorly defined.
Hypothesis: In a substudy of a protocol investigating the clinical effects of transendocardial CD34+ cell transplantation in DCM we sought to evaluate the effects of this therapy on diastolic parameters.
Methods: From May 2013 until January 2014 we enrolled 38 DCM patients with NYHA class III and LVEF <40%. All patients underwent transendocardial CD34+ cell transplantation. Peripheral blood CD34+ cells were mobilized by G-CSF, collected via apheresis, and injected transendocardially in the areas of electomechanical missmatch. Patients were followed for 1 year after the procedure.
Results: At baseline, diastolic parametes were impaired (E/Em≥15) in 18 patients (Group A), and normal (E/Em<15) in 20 patients (Group B). The two groups did not differ in age (54±9 years vs. 52±10 years; P=0.62), gender (male: 85% vs. 78%; P=0.57), or LVEF (31±7 % vs. 34±6 %; P=0.37). When compared to Group B patients in Group A had more segments with myocardial scar (4.9±2.7 vs. 2.7±2.9; P=0.03). and myocardial hibernation (2.2±1.6 vs. 0.9±1.1; P=0.02) on electroanatomical mapping. The number of injected CD34+ cells was 92.6±45.8 million in Group A, and 139.2±85.3 million in Group B (P=0.08). During follow-up there was an improvement in diastolic parameters in Group A (E/Em: from 24.3±12.1 to 16.3±8.0; P=0.005), but not in Group B (E/Em: from 10.2±3.7 to 13.2±9.1; P=0.19). Accordingly, in Group A, we found an increase in 6-minute walk distance (from 463±83 m to 546±91 m; P=0.03), and a decrease in NT-proBNP (from 2140±1743 pg/mL to 863±836 pg/mL; P=0.02).
Conclusions: In non-ischemic DCM, diastolic parametes appear to correlate with areas of myocardial scar and hibernation on electroanatomical mapping. Transendocardial CD34+ cell transplantation may improve diastolic parameters in this patient cohort.
Author Disclosures: M. Bervar: None. M. Kozelj: None. G. Poglajen: None. M. Sever: None. M. Cukjati: None. P. Cernelc: None. F. Haddad: None. J.C. Wu: None. B. Vrtovec: None.
- © 2015 by American Heart Association, Inc.