Transendocardial CD34 Cell Therapy Improves Local Mechanical Dyssynchrony in Patients With Nonischemic Dilated Cardiomyopathy
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 w...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2022-03-01
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| Series: | Cell Transplantation |
| Online Access: | https://doi.org/10.1177/09636897221080384 |
| _version_ | 1818317282449817600 |
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| author | Neža Žorž Gregor Poglajen Sabina Frljak Ivan Knezevič Bojan Vrtovec |
| author_facet | Neža Žorž Gregor Poglajen Sabina Frljak Ivan Knezevič Bojan Vrtovec |
| author_sort | Neža Žorž |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-13T09:34:51Z |
| format | Article |
| id | doaj.art-5062b8ab3eb746dab7a3273fb820ebb6 |
| institution | Directory Open Access Journal |
| issn | 1555-3892 |
| language | English |
| last_indexed | 2024-12-13T09:34:51Z |
| publishDate | 2022-03-01 |
| publisher | SAGE Publishing |
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| series | Cell Transplantation |
| spelling | doaj.art-5062b8ab3eb746dab7a3273fb820ebb62022-12-21T23:52:23ZengSAGE PublishingCell Transplantation1555-38922022-03-013110.1177/09636897221080384Transendocardial CD34 Cell Therapy Improves Local Mechanical Dyssynchrony in Patients With Nonischemic Dilated CardiomyopathyNeža Žorž0Gregor Poglajen1Sabina Frljak2Ivan Knezevič3Bojan Vrtovec4Advanced Heart Failure and Transplantation Center, Department of Cardiology, University Medical Center Ljubljana, Ljubljana, SloveniaDepartment of Internal Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, SloveniaAdvanced Heart Failure and Transplantation Center, Department of Cardiology, University Medical Center Ljubljana, Ljubljana, SloveniaDepartment of Cardiovascular Surgery, University Medical Center Ljubljana, Ljubljana, SloveniaDepartment of Internal Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, SloveniaWe 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.https://doi.org/10.1177/09636897221080384 |
| spellingShingle | Neža Žorž Gregor Poglajen Sabina Frljak Ivan Knezevič Bojan Vrtovec Transendocardial CD34 Cell Therapy Improves Local Mechanical Dyssynchrony in Patients With Nonischemic Dilated Cardiomyopathy Cell Transplantation |
| title | Transendocardial CD34 Cell Therapy Improves Local Mechanical Dyssynchrony in Patients With Nonischemic Dilated Cardiomyopathy |
| title_full | Transendocardial CD34 Cell Therapy Improves Local Mechanical Dyssynchrony in Patients With Nonischemic Dilated Cardiomyopathy |
| title_fullStr | Transendocardial CD34 Cell Therapy Improves Local Mechanical Dyssynchrony in Patients With Nonischemic Dilated Cardiomyopathy |
| title_full_unstemmed | Transendocardial CD34 Cell Therapy Improves Local Mechanical Dyssynchrony in Patients With Nonischemic Dilated Cardiomyopathy |
| title_short | Transendocardial CD34 Cell Therapy Improves Local Mechanical Dyssynchrony in Patients With Nonischemic Dilated Cardiomyopathy |
| title_sort | transendocardial cd34 cell therapy improves local mechanical dyssynchrony in patients with nonischemic dilated cardiomyopathy |
| url | https://doi.org/10.1177/09636897221080384 |
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