title: Stem cell therapy for the treatment of nonischemic cardiomyopathy: a systematic review of the literature and meta-analysis of randomized controlled trials.
abstract: BACKGROUND
  Stem cell (SC) therapy improves left ventricular function and dimensions in ischemic heart disease. Few small-scale trials have studied the effects of SC therapy on nonischemic cardiomyopathy (CMP), the leading cause of heart transplantation in the adults. The objectives were to gain a better insight into the effects of SC therapy for nonischemic CMP by conducting a systematic review of the literature and meta-analysis of randomized controlled trials.
  
  
  METHODS
  Medline, EBM Reviews-Cochrane Central Register of Controlled Trials, Embase, and the ClinicalTrials.gov databases were screened for randomized controlled trials involving SC for treatment of nonischemic CMP. Weighted mean differences of improvement of left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter (LVEDD) were calculated using a random effect analysis model.
  
  
  RESULTS
  Four trials were included in this meta-analysis (244 patients). The weighted mean LVEF improvement was 4.87% (95% confidence interval, 1.32-8.43%) in the treatment group compared with the control group (P = 0.01). The weighted mean decrease of LVEDD in the treatment group was of -2.19 mm (95% confidence interval, -5.69 to 1.30) compared with the control group (P = 0.22). On subgroup analysis, results were similar in studies involving peripheral CD34-positive or bone marrow-derived mononuclear cells (P = 0.33 for subgroup differences).
  
  
  CONCLUSIONS
  This is the first meta-analysis to show that for the treatment of nonischemic CMP, SC therapy might improve LVEF, but not LVEDD. Further trials should aim to circumscribe the optimal SC regimen in this setting, and to assess long-term clinical outcomes as primary end points.
authors.affiliation: Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada; Centre Hospitalier de l'Université de Montréal (CHUM) Research Center, Montréal, Québec, Canada.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Marquis-Gravel
authors.affiliation: Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada; Division of Cardiac Surgery, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada.
authors.forename: Louis-Mathieu
authors.initials: LM
authors.lastname: Stevens
authors.affiliation: Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada; Centre Hospitalier de l'Université de Montréal (CHUM) Research Center, Montréal, Québec, Canada; Division of Cardiology, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada.
authors.forename: Samer
authors.initials: S
authors.lastname: Mansour
authors.affiliation: Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada.
authors.forename: Robert
authors.initials: R
authors.lastname: Avram
authors.affiliation: Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada; Centre Hospitalier de l'Université de Montréal (CHUM) Research Center, Montréal, Québec, Canada; Division of Cardiac Surgery, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada. Electronic address: noiseuxn@videotron.ca.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Noiseux
mesh_terms: D009202:Cardiomyopathies / Q000628:therapy*; D064987:Cell- and Tissue-Based Therapy / Q000379:methods*; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D033581:Stem Cell Transplantation; D014182:Transplantation, Autologous