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Rev Esp Cardiol (Engl Ed). 2013 Jun;66(6):450-7. doi: 10.1016/j.rec.2012.11.013. Epub 2013 Mar 16.

Functional improvement in patients with dilated cardiomyopathy after the intracoronary infusion of autologous bone marrow mononuclear cells.

Author information

1
Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, Spain. Electronic address: grupo_corpal@arrakis.es.
2
Unidad de Terapia Celular, Hospital Universitario Reina Sofía, Córdoba, Spain.
3
Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, Spain.

Abstract

INTRODUCTION AND OBJECTIVES:

Different studies have shown improvement in patients with idiopathic nonischemic dilated cardiomyopathy treated with cell-therapy. However, factors influencing responsiveness are not well known. This trial investigates functional changes and factors influencing the 6-month gain in ejection fraction in 27 patients with dilated cardiomiopathy treated with intracoronary cell-therapy.

METHODS:

Patients received intracoronary infusion of autologous bone-marrow mononuclear cells (mean infused, 10.2 [2.9]×10(8)). Flow cytometry and functional analyses of the cells were also performed.

RESULTS:

The 6-month angiographic gain in ejection fraction ranged from -9% to 34% (mean, 9%). These changes were distinguished into 2 groups: 21 patients (78%) with a significant improvement at the 6-month evaluation (mean gain, 14 [7]%), and 6 patients who had no response (mean gain, -5 [3]%). The responders were younger as compared to the nonresponders (50 [12] years vs 62 [9] years; P<.04). There was an inverse correlation (r=-0.41; P<.003) between the gain in ejection fraction and the high density lipoprotein level, suggesting higher functional gain with low high density lipoprotein levels. The 24 h migratory capability of the infused cells was significantly reduced in the responders' group (5.4 [1.7]×10(8) vs 8.1 [2.3]×10(8); P<.009 for vascular endothelial growth factor and 5.8 [1.7]×10(8) vs 8.4 [2.9]×10(8); P<.002 for stromal cell-derived factor-1).

CONCLUSIONS:

Younger patients with dilated cardiomiopathy and lower plasma high density lipoprotein levels gain greater benefit from intracoronary cell-therapy. Functional improvement also seems to be enhanced by a lower migratory capacity of the infused cells.

PMID:
24776047
DOI:
10.1016/j.rec.2012.11.013
[Indexed for MEDLINE]
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