Download The acute and long-term effects of intracoronary Stem cell

The acute and long-term effects of
intracoronary Stem cell Transplantation
in 191 patients with chronic heARt
failure: the STAR-heart study
Bodo-Eckehard Strauer*, Muhammad Yousef and
Christiana M. Schannwell
+
Author Affiliations
From the Department of Medicine, Division of
Cardiology, Pneumology and Angiology, HeinrichHeine-University of Düsseldorf, Moorenstr 5,
40225 Düsseldorf, Germany
*Corresponding author. Tel: +49 211 8104848, Fax:
+49 211 8118396, Email: [email protected]
Received February 11, 2010.
Revision received April 12, 2010.
Accepted April 16, 2010.
Abstract
Aims Despite accumulated evidence that
intracoronary bone marrow cell (BMC) therapy may
be beneficial in acute myocardial infarction,
there are only limited data available on the
effectiveness of BMC's in chronic heart failure.
The aim of this study was to quantitatively
investigate ventricular haemodynamics, geometry,
and contractility as well as the long-term
clinical outcome of BMC treated patients with
reduced left ventricular ejection fraction (LVEF)
due to chronic ischaemic cardiomyopathy.
Methods and results Patients with chronic heart
failure (n = 391 LVEF ≤35%) due to ischaemic
cardiomyopathy were enrolled in the present study.
Of these, 191 patients (mean NYHA class 3.22)
underwent intracoronary BMC therapy. The control
group (mean NYHA class 3.06) consisted of 200
patients with comparable LVEF. Assessments of
haemodynamics at rest and exercise, quantitative
ventriculography, spiroergometry, 24 h Holter ECG,
late potentials, and heart rate variability were
analysed. Over 3 months to 5 years after
intracoronary BMC therapy there was a significant
improvement in haemodynamics (e.g. LVEF, cardiac
index), exercise capacity, oxygen uptake, and LV
contractility. Importantly, there was a
significant decrease in long-term mortality in the
BMC treated patients compared with the control
group.
Conclusion Intracoronary BMC therapy improves
ventricular performance, quality of life and
survival in patients with heart failure. These
effects were present when BMC were administered in
addition to standard therapeutic regimes. No side
effects were observed.
Key words
Ischaemic cardiomyopathy Chronic heart failure
Bone marrow cell therapy Remodelling Mortality
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