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Effects of Transendocardial CD34(+) Cell Transplantation on Diastolic Parameters in Patients with Nonischemic Dilated Cardiomyopathy

We sought to evaluate the physiological background and the effects of CD34(+) cell transplantation on diastolic parameters in nonischemic dilated cardiomyopathy patients (DCM). We enrolled 38 DCM patients with NYHA class III and LVEF < 40% who underwent transendocardial CD34(+) cell transplantati...

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Autores principales: Bervar, Mojca, Kozelj, Mirta, Poglajen, Gregor, Sever, Matjaz, Zemljic, Gregor, Frljak, Sabina, Cukjati, Marko, Cernelc, Peter, Haddad, François, Vrtovec, Bojan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5689759/
https://www.ncbi.nlm.nih.gov/pubmed/28296283
http://dx.doi.org/10.1002/sctm.16-0331
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author Bervar, Mojca
Kozelj, Mirta
Poglajen, Gregor
Sever, Matjaz
Zemljic, Gregor
Frljak, Sabina
Cukjati, Marko
Cernelc, Peter
Haddad, François
Vrtovec, Bojan
author_facet Bervar, Mojca
Kozelj, Mirta
Poglajen, Gregor
Sever, Matjaz
Zemljic, Gregor
Frljak, Sabina
Cukjati, Marko
Cernelc, Peter
Haddad, François
Vrtovec, Bojan
author_sort Bervar, Mojca
collection PubMed
description We sought to evaluate the physiological background and the effects of CD34(+) cell transplantation on diastolic parameters in nonischemic dilated cardiomyopathy patients (DCM). We enrolled 38 DCM patients with NYHA class III and LVEF < 40% who underwent transendocardial CD34(+) cell transplantation. Peripheral blood CD34(+) cells were mobilized by G‐CSF, collected via apheresis, and injected transendocardially in the areas of myocardial hibernation. Patients were followed for 1 year. At baseline, estimated filling pressures were significantly elevated (E/e′ ≥ 15) in 18 patients (Group A), and moderately elevated (E/e ′< 15) in 20 patients (Group B). The groups did not differ in age (54 ± 9 years vs. 52 ± 10 years; p = .62), gender (male: 85% vs. 78%; p = .57), or LVEF (31 ± 7% vs. 34 ± 6%; p = .37). When compared to Group B patients in Group A had more segments with myocardial scar (4.9 ± 2.7 vs. 2.7 ± 2.9; p = .03), myocardial hibernation (2.2 ± 1.6 vs. 0.9 ± 1.1; p = .02), and longer average local relaxation time on electroanatomical mapping (378 ± 41 ms vs. 333 ± 34 ms, p = .01). During follow‐up there was an improvement in diastolic parameters in Group A (E/e′: from 24.3 ± 12.1 to 16.3 ± 8.0; p = .005), but not in Group B (E/e′: from 10.2 ± 3.7 to 13.2 ± 9.1; p = .19). Accordingly, in Group A, we found an increase in 6‐minute walk distance (from 463 ± 83 m to 546 ± 91 m; p = .03), and a decrease in NT‐proBNP (from 2140 ± 1743 pg/ml to 863 ± 836 pg/ml; p = .02). In nonischemic DCM, diastolic dysfunction appears to correlate with areas of myocardial scar and hibernation. Transendocardial CD34(+) cell transplantation may improve diastolic parameters in this patient cohort. Stem Cells Translational Medicine 2017;6:1515–1521
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spelling pubmed-56897592017-11-24 Effects of Transendocardial CD34(+) Cell Transplantation on Diastolic Parameters in Patients with Nonischemic Dilated Cardiomyopathy Bervar, Mojca Kozelj, Mirta Poglajen, Gregor Sever, Matjaz Zemljic, Gregor Frljak, Sabina Cukjati, Marko Cernelc, Peter Haddad, François Vrtovec, Bojan Stem Cells Transl Med Translational Research Articles and Reviews We sought to evaluate the physiological background and the effects of CD34(+) cell transplantation on diastolic parameters in nonischemic dilated cardiomyopathy patients (DCM). We enrolled 38 DCM patients with NYHA class III and LVEF < 40% who underwent transendocardial CD34(+) cell transplantation. Peripheral blood CD34(+) cells were mobilized by G‐CSF, collected via apheresis, and injected transendocardially in the areas of myocardial hibernation. Patients were followed for 1 year. At baseline, estimated filling pressures were significantly elevated (E/e′ ≥ 15) in 18 patients (Group A), and moderately elevated (E/e ′< 15) in 20 patients (Group B). The groups did not differ in age (54 ± 9 years vs. 52 ± 10 years; p = .62), gender (male: 85% vs. 78%; p = .57), or LVEF (31 ± 7% vs. 34 ± 6%; p = .37). When compared to Group B patients in Group A had more segments with myocardial scar (4.9 ± 2.7 vs. 2.7 ± 2.9; p = .03), myocardial hibernation (2.2 ± 1.6 vs. 0.9 ± 1.1; p = .02), and longer average local relaxation time on electroanatomical mapping (378 ± 41 ms vs. 333 ± 34 ms, p = .01). During follow‐up there was an improvement in diastolic parameters in Group A (E/e′: from 24.3 ± 12.1 to 16.3 ± 8.0; p = .005), but not in Group B (E/e′: from 10.2 ± 3.7 to 13.2 ± 9.1; p = .19). Accordingly, in Group A, we found an increase in 6‐minute walk distance (from 463 ± 83 m to 546 ± 91 m; p = .03), and a decrease in NT‐proBNP (from 2140 ± 1743 pg/ml to 863 ± 836 pg/ml; p = .02). In nonischemic DCM, diastolic dysfunction appears to correlate with areas of myocardial scar and hibernation. Transendocardial CD34(+) cell transplantation may improve diastolic parameters in this patient cohort. Stem Cells Translational Medicine 2017;6:1515–1521 John Wiley and Sons Inc. 2017-03-11 /pmc/articles/PMC5689759/ /pubmed/28296283 http://dx.doi.org/10.1002/sctm.16-0331 Text en © 2017 The Authors Stem Cells Translational Medicine published by Wiley Periodicals, Inc. on behalf of AlphaMed Press This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs (http://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Translational Research Articles and Reviews
Bervar, Mojca
Kozelj, Mirta
Poglajen, Gregor
Sever, Matjaz
Zemljic, Gregor
Frljak, Sabina
Cukjati, Marko
Cernelc, Peter
Haddad, François
Vrtovec, Bojan
Effects of Transendocardial CD34(+) Cell Transplantation on Diastolic Parameters in Patients with Nonischemic Dilated Cardiomyopathy
title Effects of Transendocardial CD34(+) Cell Transplantation on Diastolic Parameters in Patients with Nonischemic Dilated Cardiomyopathy
title_full Effects of Transendocardial CD34(+) Cell Transplantation on Diastolic Parameters in Patients with Nonischemic Dilated Cardiomyopathy
title_fullStr Effects of Transendocardial CD34(+) Cell Transplantation on Diastolic Parameters in Patients with Nonischemic Dilated Cardiomyopathy
title_full_unstemmed Effects of Transendocardial CD34(+) Cell Transplantation on Diastolic Parameters in Patients with Nonischemic Dilated Cardiomyopathy
title_short Effects of Transendocardial CD34(+) Cell Transplantation on Diastolic Parameters in Patients with Nonischemic Dilated Cardiomyopathy
title_sort effects of transendocardial cd34(+) cell transplantation on diastolic parameters in patients with nonischemic dilated cardiomyopathy
topic Translational Research Articles and Reviews
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5689759/
https://www.ncbi.nlm.nih.gov/pubmed/28296283
http://dx.doi.org/10.1002/sctm.16-0331
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