Author/Editor		Vrtovec, Bojan; Sever, Matjaž; Domanovič, Dragoslav; Ležaič, Luka; Poglajen, Gregor; Černelč, Peter; Haddad, F.; Torre-Amione, Guillermo
Title		Long-term effects of stem cell transplantation in heart failure
Translated title		Dolgoročni učinki presaditve matičnih celic pri bolnikih s srčnim popuščanjem
Type		članek
Source		In: 4. kongres hematologov in transfuziologov Slovenije z mednarodno udeležbo : Olimje, 12.-14. 4. 2012 : Olimje, 12.-14. April 2012 Ljubljana : Slovensko zdravniško društvo
Vol. and No.		Letnik 81, št. suppl.
Publication year		2012
Volume		str. II-373-II-383
Language		eng
Abstract		Background: We investigated long-term effects of intracoronary transplantationof CD34+ cells in patients with dilated cardiomyopathy (DCM). Methods: Of 110 DCM patients, 55 were randomized to CD34+ cell transplantation(SC) group, and 55 patients received no cell therapy (controls). In the SC group, peripheral CD34+cells were mobilized by G-CSF andcollected via apheresis. Patients underwent myocardial scintigraphy and CD34+ cells were injected in the 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 withan increase in LVEF (from 24.3 Ž 6.5 % to 30.0 Ž 5.1 %; P = 0.02), an increase in 6-minute walk distance (from 344 Ž 90 m to 477 Ž 130 m; P < 0.001), and a decrease in NT-proBNP (from 2322 Ž 1234 pg/mL to 1011 Ž 893 pg/mL; P < 0.01). During followup, 27 (25 %) patients died and 9 (8 %) underwent heart transplantation. Of the 27 deaths, 13 were attributed to pump failure, and 14 to sudden cardiac death. Total mortality was lower in SC group(8/55 [14 %]) than in controls (19/55 [35 %]) (P = 0.01). The same was true of pump failure (3/55 [5 %] vs. 10/55 [18 %], P = 0.03), but not of sudden cardiac death (5/55 [9 %] vs. 9/55 [16 %], P = 0.39). SC therapy was anindependent predictor of outcome on multivariable analysis (P = 0.04). Conclusions: Intracoronary stem cell transplantation may be associated with improved ventricular remodeling, exercise tolerance, and longterm survival in patients with DCM.
Keywords		matične celice dilativna kardiomiopatija srčno popuščanje stem cells dilated cardiomyopathy heart failure