title: Electroanatomic Properties of the Myocardium Predict Response to CD34+ Cell Therapy in Patients With Ischemic and Nonischemic Heart Failure.
abstract: BACKGROUND
  We investigated a correlation between electromechanical properties of the myocardium and response to CD34+ cell therapy in patients with chronic heart failure.
  
  
  RESULTS
  We enrolled 40 patients with ischemic cardiomyopathy (ICM) and 40 with nonischemic dilated cardiomyopathy (DCM). All patients were in New York Heart Association functional class III and had a left ventricular ejection fraction (LVEF) <40%. CD34+ cells were mobilized by granulocyte colony-stimulating factor and collected via apheresis. Electroanatomic mapping was performed to define areas of myocardial scar and hibernation, and CD34+ cells were injected transendocardially in the hibernating areas. Patient were followed for 6 months; responders were defined as patients with LVEF increase of >5%. At baseline, the groups did not differ in sex, LVEF, creatinine, N-terminal pro-B-type natriuretic peptide or electroanatomic parameters (scar area: 53 ± 18% in ICM vs 55 ± 23% in DCM [P = .83]; hibernating area: 23 ± 13% vs 22 ± 12% [P = .56]). At 6 months we found similar rates of responders in both groups (60% in ICM vs 65% in DCM [P = .95]). When compared with nonresponders, responders had less myocardial scar (47 ± 17% vs 58 ± 15% [P = .003]).
  
  
  CONCLUSIONS
  In patients with chronic heart failure due to ICM and DCM we observed similar electroanatomic properties of the myocardium. In both groups, lower myocardial scar burden was associated with better clinical response to CD34+ cell therapy.
authors: Advanced Heart Failure and Transplantation Center, UMC Ljubljana, Slovenia.
authors: Gregor
authors: G
authors: Zemljic
authors: Advanced Heart Failure and Transplantation Center, UMC Ljubljana, Slovenia.
authors: Gregor
authors: G
authors: Poglajen
authors: Department of Hematology, UMC Ljubljana, Slovenia.
authors: Matjaz
authors: M
authors: Sever
authors: National Blood Transfusion Institute, Ljubljana, Slovenia.
authors: Marko
authors: M
authors: Cukjati
authors: Advanced Heart Failure and Transplantation Center, UMC Ljubljana, Slovenia.
authors: Sabina
authors: S
authors: Frljak
authors: Advanced Heart Failure and Transplantation Center, UMC Ljubljana, Slovenia.
authors: Vesna
authors: V
authors: Androcec
authors: Department of Hematology, UMC Ljubljana, Slovenia.
authors: Peter
authors: P
authors: Cernelc
authors: Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California, USA.
authors: François
authors: F
authors: Haddad
authors: Advanced Heart Failure and Transplantation Center, UMC Ljubljana, Slovenia; Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California, USA. Electronic address: bvrtovec@stanford.edu.
authors: Bojan
authors: B
authors: Vrtovec
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D018952:Antigens, CD34 / Q000008:administration & dosage*; D002311:Cardiomyopathy, Dilated / Q000150:complications* / Q000175:diagnosis; D064987:Cell- and Tissue-Based Therapy / Q000379:methods*; D002908:Chronic Disease; D004452:Echocardiography; D005080:Exercise Test / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000209:etiology* / Q000401:mortality / Q000628:therapy*; D006801:Humans; D021621:Imaging, Three-Dimensional; D015552:Injections, Intralesional; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017202:Myocardial Ischemia / Q000150:complications* / Q000175:diagnosis; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D012720:Severity of Illness Index; D013318:Stroke Volume / Q000502:physiology; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D020257:Ventricular Remodeling / Q000502:physiology
chemical_list: D018952:Antigens, CD34; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: Heart failure; cell therapy; scar burden