Effect of Transendocardial Delivery of Autologous Bone Marrow Mononuclear Cells on Functional Capacity, Left Ventricular Function, and Perfusion in Chronic Heart Failure The FOCUS-CCTRN Trial

Title
Effect of Transendocardial Delivery of Autologous Bone Marrow Mononuclear Cells on Functional Capacity, Left Ventricular Function, and Perfusion in Chronic Heart Failure The FOCUS-CCTRN Trial
Author(s)
Emerson C. Perin[Emerson C. Perin]James T. Willerson[James T. Willerson]Carl J. Pepine[Carl J. Pepine]Timothy D. Henry[Timothy D. Henry]Stephen G. Ellis[Stephen G. Ellis]David X. M. Zhao[David X. M. Zhao]Guilherme V. Silva[Guilherme V. Silva]곽민정Dejian Lai[Dejian Lai]James D. Thomas[James D. Thomas]
Keywords
RANDOMIZED CONTROLLED-TRIAL; ACUTE MYOCARDIAL-INFARCTION; CORONARY-ARTERY-DISEASE; RESEARCH NETWORK CCTRN; STEM-CELLS; PROGENITOR CELLS; TRANSCORONARY TRANSPLANTATION; INTRAMYOCARDIAL INJECTION; F-18 FLUORODEOXYGLUCOSE; METABOLIC-ACTIVITY
Issue Date
201204
Publisher
AMER MEDICAL ASSOC
Citation
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, v.307, no.16, pp.1717 - 1726
Abstract
Context Previous studies using autologous bone marrow mononuclear cells (BMCs) in patients with ischemic cardiomyopathy have demonstrated safety and suggested efficacy. Objective To determine if administration of BMCs through transendocardial injections improves myocardial perfusion, reduces left ventricular end-systolic volume (LVESV), or enhances maximal oxygen consumption in patients with coronary artery disease or LV dysfunction, and limiting heart failure or angina. Design, Setting, and Patients Aphase 2 randomized double-blind, placebo-controlled trial of symptomatic patients (New York Heart Association classification II-III or Canadian Cardiovascular Society classification II-IV) with a left ventricular ejection fraction of 45% or less, a perfusion defect by single-photon emission tomography (SPECT), and coronary artery disease not amenable to revascularization who were receiving maximal medical therapy at 5 National Heart, Lung, and Blood Institute-sponsored Cardiovascular Cell Therapy Research Network (CCTRN) sites between April 29, 2009, and April 18, 2011. Intervention Bone marrow aspiration (isolation of BMCs using a standardized automated system performed locally) and transendocardial injection of 100 million BMCs or placebo (ratio of 2 for BMC group to 1 for placebo group). Main Outcome Measures Co-primary end points assessed at 6 months: changes in LVESV assessed by echocardiography, maximal oxygen consumption, and reversibility on SPECT. Phenotypic and functional analyses of the cell product were performed by the CCTRN biorepository core laboratory. Results Of 153 patients who provided consent, a total of 92 (82 men; average age: 63 years) were randomized (n=61 in BMC group and n=31 in placebo group). Changes in LVESV index (-0.9 mL/m(2) [95% CI, -6.1 to 4.3]; P=.73), maximal oxygen consumption (1.0 [95% CI, -0.42 to 2.34]; P=.17), and reversible defect (-1.2 [95% CI, -12.50 to 10.12]; P=.84) were not statistically significant. There were no differences found in any of the secondary outcomes, including percent myocardial defect, total defect size, fixed defect size, regional wall motion, and clinical improvement. Conclusion Among patients with chronic ischemic heart failure, transendocardial injection of autologous BMCs compared with placebo did not improve LVESV, maximal oxygen consumption, or reversibility on SPECT.
URI
http://hdl.handle.net/YU.REPOSITORY/28700http://dx.doi.org/10.1001/jama.2012.418
ISSN
0098-7484
Appears in Collections:
이과대학 > 통계학과 > Articles
Files in This Item:
There are no files associated with this item.
Export
RIS (EndNote)
XLS (Excel)
XML


qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

BROWSE