Kang Cheng1, Feng Wu, Feng Cao. 1. Department of Cardiology, XiJing Hospital, Fourth Military Medical University, Xi'an ShanXi 710032, China. Electronic address: chengkang20091224@foxmail.com.
Abstract
BACKGROUND: Intramyocardial cellular delivery provides a promising therapeutic strategy for ischaemic cardiac dysfunction. However, individual studies have reported controversial results. METHODS: Relevant trials were identified by systematic search of MEDLINE, EMBASE, the Cochrane database, and CINAH database. Studies, which applied randomised design and compared intramyocardial cell injection with placebo or optimal medical therapy in patients with chronic ischaemic heart failure, were eligible. RESULTS: A total of 210 participants in five randomised controlled trials were included. The pooled analyses showed that cell therapy did not significantly improve left ventricular ejection fraction compared with the control (95% CI -0.35 to 0.31, p=0.91). Nevertheless, cell therapy provided a benefit in increasing 6-min walk distance (95% CI 21.09 m-142.62 m, p=0.008), improving MLHF score (95% CI -25.21 to -3.55, p=0.009), and lowering the incidence of NYHA functional class deterioration (95% CI 0.05-0.76, p=0.02). However, the novel procedure did not result in a significant reduction in all-cause mortality. Conversely, cell therapy did not significantly increase the risk of ventricular tachycardia or acute heart failure, however we were underpowered to evaluate these endpoints. CONCLUSIONS: Intramyocardial cell therapy was feasible in treating patients with ischaemic heart failure.
BACKGROUND: Intramyocardial cellular delivery provides a promising therapeutic strategy for ischaemic cardiac dysfunction. However, individual studies have reported controversial results. METHODS: Relevant trials were identified by systematic search of MEDLINE, EMBASE, the Cochrane database, and CINAH database. Studies, which applied randomised design and compared intramyocardial cell injection with placebo or optimal medical therapy in patients with chronic ischaemic heart failure, were eligible. RESULTS: A total of 210 participants in five randomised controlled trials were included. The pooled analyses showed that cell therapy did not significantly improve left ventricular ejection fraction compared with the control (95% CI -0.35 to 0.31, p=0.91). Nevertheless, cell therapy provided a benefit in increasing 6-min walk distance (95% CI 21.09 m-142.62 m, p=0.008), improving MLHF score (95% CI -25.21 to -3.55, p=0.009), and lowering the incidence of NYHA functional class deterioration (95% CI 0.05-0.76, p=0.02). However, the novel procedure did not result in a significant reduction in all-cause mortality. Conversely, cell therapy did not significantly increase the risk of ventricular tachycardia or acute heart failure, however we were underpowered to evaluate these endpoints. CONCLUSIONS: Intramyocardial cell therapy was feasible in treating patients with ischaemic heart failure.
Authors: Radoslaw Litwinowicz; Bogusław Kapelak; Jerzy Sadowski; Anna Kędziora; Krzysztof Bartus Journal: Kardiochir Torakochirurgia Pol Date: 2018-09-24
Authors: Annu Nummi; Tuomo Nieminen; Tommi Pätilä; Milla Lampinen; Miia L Lehtinen; Sari Kivistö; Miia Holmström; Erika Wilkman; Kari Teittinen; Mika Laine; Juha Sinisalo; Markku Kupari; Esko Kankuri; Tatu Juvonen; Antti Vento; Raili Suojaranta; Ari Harjula Journal: Pilot Feasibility Stud Date: 2017-12-20