Gregor Zemljic1, Gregor Poglajen1, Matjaz Sever2, Marko Cukjati3, Sabina Frljak1, Vesna Androcec1, Peter Cernelc2, François Haddad4, Bojan Vrtovec5. 1. Advanced Heart Failure and Transplantation Center, UMC Ljubljana, Slovenia. 2. Department of Hematology, UMC Ljubljana, Slovenia. 3. National Blood Transfusion Institute, Ljubljana, Slovenia. 4. Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California, USA. 5. Advanced Heart Failure and Transplantation Center, UMC Ljubljana, Slovenia; Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California, USA. Electronic address: bvrtovec@stanford.edu.
Abstract
BACKGROUND: We investigated a correlation between electromechanical properties of the myocardium and response to CD34+ cell therapy in patients with chronic heart failure. METHODS AND RESULTS: We enrolled 40 patients with ischemic cardiomyopathy (ICM) and 40 with nonischemic dilated cardiomyopathy (DCM). All patients were in New York Heart Association functional class III and had a left ventricular ejection fraction (LVEF) <40%. CD34+ cells were mobilized by granulocyte colony-stimulating factor and collected via apheresis. Electroanatomic mapping was performed to define areas of myocardial scar and hibernation, and CD34+ cells were injected transendocardially in the hibernating areas. Patient were followed for 6 months; responders were defined as patients with LVEF increase of >5%. At baseline, the groups did not differ in sex, LVEF, creatinine, N-terminal pro-B-type natriuretic peptide or electroanatomic parameters (scar area: 53 ± 18% in ICM vs 55 ± 23% in DCM [P = .83]; hibernating area: 23 ± 13% vs 22 ± 12% [P = .56]). At 6 months we found similar rates of responders in both groups (60% in ICM vs 65% in DCM [P = .95]). When compared with nonresponders, responders had less myocardial scar (47 ± 17% vs 58 ± 15% [P = .003]). CONCLUSIONS: In patients with chronic heart failure due to ICM and DCM we observed similar electroanatomic properties of the myocardium. In both groups, lower myocardial scar burden was associated with better clinical response to CD34+ cell therapy.
BACKGROUND: We investigated a correlation between electromechanical properties of the myocardium and response to CD34+ cell therapy in patients with chronic heart failure. METHODS AND RESULTS: We enrolled 40 patients with ischemic cardiomyopathy (ICM) and 40 with nonischemic dilated cardiomyopathy (DCM). All patients were in New York Heart Association functional class III and had a left ventricular ejection fraction (LVEF) <40%. CD34+ cells were mobilized by granulocyte colony-stimulating factor and collected via apheresis. Electroanatomic mapping was performed to define areas of myocardial scar and hibernation, and CD34+ cells were injected transendocardially in the hibernating areas. Patient were followed for 6 months; responders were defined as patients with LVEF increase of >5%. At baseline, the groups did not differ in sex, LVEF, creatinine, N-terminal pro-B-type natriuretic peptide or electroanatomic parameters (scar area: 53 ± 18% in ICM vs 55 ± 23% in DCM [P = .83]; hibernating area: 23 ± 13% vs 22 ± 12% [P = .56]). At 6 months we found similar rates of responders in both groups (60% in ICM vs 65% in DCM [P = .95]). When compared with nonresponders, responders had less myocardial scar (47 ± 17% vs 58 ± 15% [P = .003]). CONCLUSIONS: In patients with chronic heart failure due to ICM and DCM we observed similar electroanatomic properties of the myocardium. In both groups, lower myocardial scar burden was associated with better clinical response to CD34+ cell therapy.
Authors: Radosław Kurzelowski; Kamil Barański; Guido Caluori; Wojciech Szot; Krzysztof Grabowski; Aleksandra Michalewska-Włudarczyk; Marcin Syzdół; Wacław Kuczmik; Anna Błach; Beata Ochała; Damian Hudziak; Jacek Wilczek; Krzysztof S Gołba; Zdenek Starek; Michał Tendera; Wojciech Wojakowski; Tomasz Jadczyk Journal: Postepy Kardiol Interwencyjnej Date: 2021-09-14 Impact factor: 1.426
Authors: Rienzi Diaz-Navarro; Gerard Urrútia; John Gf Cleland; Daniel Poloni; Francisco Villagran; Roberto Acosta-Dighero; Shrikant I Bangdiwala; Gabriel Rada; Eva Madrid Journal: Cochrane Database Syst Rev Date: 2021-07-21