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CD34+ Cell Transplantation Improves Right Ventricular Function in Patients with Nonischemic Dilated Cardiomyopathy
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CD34+ Cell Transplantation Improves Right Ventricular Function in Patients with Nonischemic Dilated Cardiomyopathy
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Journal Article
CD34+ Cell Transplantation Improves Right Ventricular Function in Patients with Nonischemic Dilated Cardiomyopathy
2018
Overview
We investigated the effects of CD34+ cell therapy on right ventricular (RV) function in patients with nonischemic dilated cardiomyopathy (DCM). We enrolled 60 patients with DCM who were randomized to CD34+ cell therapy (Stem Cells (SC) Group n = 30), or no cell therapy (Controls, n = 30). The SC Group received granulocyte‐colony stimulating factor, and CD34+ cells were collected by apheresis and injected transendocardially. Patients were followed for 6 months. At baseline, the groups did not differ in age, gender, left ventricular ejection fraction, N‐terminal probrain natriuretic peptide, or parameters of RV function. At 6 months, we found a significant improvement in RV function in the SC Group (tricuspid annular plane systolic excursion [TAPSE]: +0.44 ± 0.64 cm, p = .001; peak systolic tissue Doppler velocity of tricuspid annulus [St]: +1.5 ± 2.1 cm/s; p = .001; percent of fractional area change [FAC]: +8.6% ± 5%, p = .01), but not in Controls (TAPSE: −0.07 ± 0.32 cm, p = .40; St: −0.1 ± 1.2 cm/s; p = .44; FAC: −1.2% ± 3.2%, p = .50). On repeat electroanatomical mapping, we found an improvement in interventricular septum viability in 19 of 30 patients from the SC Group; this correlated with the improvements in RV function (13/19 in the improved septum group versus 3/11 in the remaining cohort, p = .029). These results suggest that patients with DCM, changes in RV function correlate with changes of viability of interventricular septum. CD34+ cell therapy appears to be associated with improved right ventricular function in this patient cohort. (Clinical Trial Registration Information: www.clinicaltrials.gov; NCT02248532). Stem Cells Translational Medicine 2018;7:168–172 Changes of right ventricular function within the 6‐month follow‐up. We found a significant improvement in tricuspid annular plane systolic excursion in the Stem Cells Group (red line) but not in the Control Group (blue line).
Publisher
Oxford University Press,John Wiley and Sons Inc
Subject
/ Cardiomyopathy, Dilated - metabolism
/ Cardiomyopathy, Dilated - physiopathology
/ Cell Transplantation - methods
/ Cell- and Tissue-Based Therapy - methods
/ Female
/ Granulocyte Colony-Stimulating Factor - metabolism
/ Heart
/ Heart Failure - physiopathology
/ Heart Septum - physiopathology
/ Heart Ventricles - metabolism
/ Heart Ventricles - physiopathology
/ Humans
/ Male
/ Natriuretic Peptide, Brain - metabolism
/ Patients
/ Peptides
/ Septum
/ Studies
/ Values
/ Velocity
