Key result
Transendocardial CD34+ cell therapy significantly decreased local mechanical dyssynchrony at cell injection sites from 17% to 13% (P = 0.00007) in patients with nonischemic dilated cardiomyopathy.
Why the study?
The study investigated the effects of cell therapy on local mechanical dyssynchrony in patients with nonischemic dilated cardiomyopathy.
Does transendocardial CD34+ cell therapy improve local mechanical dyssynchrony in patients with nonischemic dilated cardiomyopathy?
Does transendocardial CD34+ cell therapy improve local mechanical dyssynchrony in patients with nonischemic dilated cardiomyopathy?
Favorable clinical effects of transendocardial CD34+ cell therapy in nonischemic dilated cardiomyopathy may be associated with a significant decrease in local mechanical dyssynchrony at cell injection sites.
Answers are grounded in this paper and cite their sources.
CD34+ cell therapy was associated with reduced local dyssynchrony in nonischemic cardiomyopathy; hypothesis-generating and requires randomized confirmation.
We investigated the effects of cell therapy on local mechanical dyssynchrony (LMD) in patients with nonischemic dilated cardiomyopathy (NICM). We analyzed electromechanical data of 30 NICM patients undergoing CD34 + cell transplantation. All patients underwent bone marrow stimulation; CD34 + cells were collected by apheresis and injected transendocardially. At baseline and at 6 months after therapy, we performed electromechanical mapping and measured unipolar voltage (UV) and LMD at cell injection sites. LMD was defined as a temporal difference between global and segmental peak systolic displacement normalized to the average duration of the RR interval. Favorable clinical response was defined as increase in the left ventricular ejection fraction (LVEF) ≥5% between baseline and 6 months. Using paired electromechanical point-by-point analysis, we were able to identify 233 sites of CD34 + cell injections in 30 patients. We found no overall differences in local UV between baseline and 6 months (10.7 ± 4.1 mV vs 10.0 ± 3.6 mV, P = 0.42). In contrast, LMD decreased significantly (17 ± 17% at baseline vs 13 ± 12% at 6 months, P = 0.00007). Favorable clinical response at 6 months was found in 19 (63%) patients (group A), and 11 (37%) patients did not respond to cell therapy (group B). At baseline, the two groups did not differ in age, gender, LVEF, or N terminal-pro brain natriuretic peptide (NT-proBNP) levels. Similarly, we found no differences in baseline UV (9.5 ± 2.9 mV in group A vs 8.6 ± 2.4 mV in group B, P = 0.41) or LMD at cell injection sites (17 ± 19% vs 16 ± 14%, P = 0.64). In contrast, at 6 months, we found higher UV in group A (10.0 ± 3.1 mV vs 7.4 ± 1.9 mV in group B, P = 0.04). Furthermore, when compared with group B, patients in group A displayed a significantly lower LMD (11 ± 12% vs 16 ± 10%, P = 0.002). Thus, it appears that favorable clinical effects of cell therapy in NICM patients may be associated with a decrease of LMD at cell injection sites.
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Žorž et al. (2022) studied Nonischemic dilated cardiomyopathy (n=30). Transendocardial CD34+ cell therapy vs. Baseline was evaluated on Change in local mechanical dyssynchrony (LMD) at cell injection sites between baseline and 6-month follow-up (p=0.00007). Transendocardial CD34+ cell therapy significantly decreased local mechanical dyssynchrony at cell injection sites from 17% to 13% (P = 0.00007) in patients with nonischemic dilated cardiomyopathy.
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