Effects of Transendocardial Stem Cell Injection on Ventricular Proarrhythmia in Patients with Ischemic Cardiomyopathy: Results from the POSEIDON and TAC-HFT Trials
| Autor: | Joshua M. Hare, James O. Coffey, Chad Brodt, Chris Healy, Alan W. Heldman, Juan F. Viles-Gonzalez, Darcy L. DiFede, Archana Ramireddy, Adam Mendizabal, Yahya Alansari, Raul D. Mitrani, Jeffrey J. Goldberger, Robert J. Myerburg, Vishal Goyal |
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| Rok vydání: | 2017 |
| Předmět: |
Cardiac arrhythmias
Male medicine.medical_specialty Cardiomyopathy 030204 cardiovascular system & hematology Placebo Ventricular tachycardia 03 medical and health sciences 0302 clinical medicine Translational Research Articles and Reviews Heart Rate Internal medicine Humans Medicine Heart rate variability 030212 general & internal medicine Aged Heart Failure Proarrhythmia Ischemic cardiomyopathy business.industry Stem Cells Arrhythmias Cardiac Cell Biology General Medicine Middle Aged medicine.disease Heart failure Ambulatory Tachycardia Ventricular Cardiology Female Cardiomyopathies business Tissue‐Specific Progenitor and Stem Cells Developmental Biology |
| Zdroj: | Stem Cells Translational Medicine |
| ISSN: | 2157-6580 2157-6564 |
| DOI: | 10.1002/sctm.16-0328 |
| Popis: | Transendocardial stem cell injection in patients with ischemic cardiomyopathy (ICM) improves left ventricular function and structure but has ill-defined effects on ventricular arrhythmias. We hypothesized that mesenchymal stem cell (MSC) implantation is not proarrhythmic. Post hoc analyses were performed on ambulatory ECGs collected from the POSEIDON and TAC-HFT trials. Eighty-eight subjects (mean age 61 ± 10 years) with ICM (mean EF 32.2% ± 9.8%) received treatment with MSC (n = 48), Placebo (n = 21), or bone marrow mononuclear cells (BMC) (n = 19). Heart rate variability (HRV) and ventricular ectopy (VE) were evaluated over 12 months. VE did not change in any group following MSC implantation. However, in patients with ≥ 1 VE run (defined as ≥ 3 consecutive premature ventricular complexes in 24 hours) at baseline, there was a decrease in VE runs at 12 months in the MSC group (p = .01), but not in the placebo group (p = .07; intergroup comparison: p = .18). In a subset of the MSC group, HRV measures of standard deviation of normal intervals was 75 ± 30 msec at baseline and increased to 87 ± 32 msec (p =.02) at 12 months, and root mean square of intervals between successive complexes was 36 ± 30 msec and increased to 58.2 ± 50 msec (p = .01) at 12 months. In patients receiving MSCs, there was no evidence for ventricular proarrhythmia, manifested by sustained or nonsustained ventricular ectopy or worsened HRV. Signals of improvement in ventricular arrhythmias and HRV in the MSC group suggest a need for further studies of the antiarrhythmic potential of MSCs. |
| Databáze: | OpenAIRE |
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