Transendocardial CD34+ Cell Therapy does not Increase the Risk of Ventricular Arrhythmias in Patients with Chronic Heart Failure

摘要

Ventricular arrhythmias (VA) are of major concern in the field of cell therapy, potentially limiting its safety and efficacy. We sought to investigate the effects of CD34~+ cell therapy on VA burden in patients with chronic heart failure (CHF). We performed registry data analysis of patients with CHF and implanted ICD/CRT devices treated with transendocardial CD 34~+ cell therapy. Demographic, echocardiographic, and biochemical parameters were analyzed. Device records were reviewed and the number and type of VA 1 year prior to and 1 year after cell therapy were analyzed. All patients underwent elec-troanatomical mapping, and myocardial scar was defined as unipolar voltage (UV) < 8.3 mV and linear local shortening (LLS) < 6%. Of 209 patients screened, 48 met inclusion criteria. The mean age of the patients was 52 years and 88% were male. Nonischemic and ischemic cardiomyopathy were present in 55% and 45% of patients. The average serum creatinine was 91+-26 mumol/L, serum bilirubin 18 +- 9 mumol/L, NT-proBNP 1767 (468, 2446) pg/mL, LVEF 27 +- 9% and 6' walk test 442+- 123 m. The average scar burden in patients with nonischemic and ischemic DCM was 58+-15% and 51 +-25% (P=0.48). No significant difference in VA burden was observed before and after cell therapy (48% vs. 44%; P=0.68). ICD activation occurred in 19% and 27% of patients before and after cell therapy (P=0.33). According to our results, transendocardial CD34~+ cell therapy does not appear to increase the risk of VA in chronic heart failure patients.