The impact of patient sex on the response to intramyocardial mesenchymal stem cell administration in patients with non-ischaemic dilated cardiomyopathy
The impact of patient sex on the response to intramyocardial mesenchymal stem cell administration in patients with non-ischaemic dilated cardiomyopathy
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DOI：
10.1093/cvr/cvaa004
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发表时间：
2020-11-01
影响因子：
10.8
通讯作者：
Hare, Joshua M.
中科院分区：
文献类型：
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作者：
Florea, Victoria;Rieger, Angela C.;Hare, Joshua M.
性别差异影响心脏病的发生、表现、预后和治疗反应。特别是，非缺血性扩张型心肌病（NIDCM）患者的表型表现在男性和女性之间存在差异。然而，对间充质干细胞（MSC）治疗的反应是否受到性别的影响仍然未知。我们假设，男性和女性NIDCM响应类似MSC therapeutic.Methods和结果交配（n = 24）和女性（n = 10）POSEIDON-DCM试验谁收到MSC通过transendothelin注射的患者进行了评估超过12个月。在基线和经内皮干细胞注射（TES！）后3个月测量内皮功能。基线时，男性射血分数（EF）低于女性（P = 0. 004），舒张末期容积（EDV; P = 0. 0002）和收缩末期容积（ESV; P= 0. 0002）高于女性。相比之下，两组的基线人口统计学特征、明尼苏达心力衰竭生活问卷（MLHFQ）和6分钟步行试验（6 MWT）相似。男性EF改善6.2个单位（P = 0.04），女性EF改善8.6个单位（P=0.04;配偶vs.女性，P = 0.57）。EDV和ESV随时间推移保持不变。MLHFQ评分，纽约心脏协会（NYHA）类，内皮祖细胞集落形成单位，和血清肿瘤坏死因子α改善相似，在两个group.Conclusion尽管在NIDCM的表型呈现在男性和女性的重大差异，这项研究是第一次证明，MSC治疗改善了各种参数在NIDCM患者的性别无关。这些发现对于性别对NIDCM细胞治疗反应的影响具有重要的临床和病理生理意义。[图形]。
Aims Sex differences impact the occurrence, presentation, prognosis, and response to therapy in heart disease. Particularly, the phenotypic presentation of patients with non-ischaemic dilated cardiomyopathy (NIDCM) differs between men and women. However, whether the response to mesenchymal stem cell (MSC) therapy is influenced by sex remains unknown. We hypothesize that males and females with NIDCM respond similarly to MSC therapy.Methods and results Mate (n = 24) and female (n = 10) patients from the POSEIDON-DCM trial who received MSCs via transendocardial injections were evaluated over 12 months. Endothelial function was measured at baseline and 3 months post transendocardial stem cell injection (TES!). At baseline, ejection fraction (EF) was lower (P = 0 .004) and enddiastolic volume (EDV; P = 0.0002) and end-systolic volume (ESV; P= 0.0002) were higher in males vs. females. In contrast, baseline demographic characteristics, Minnesota Living with Heart Failure Questionnaire (MLHFQ), and 6min walk test (6MWT) were similar between groups. EF improved in males by 6.2 units (P = 0.04) and in females by 8.6 units (P=0.04; mates vs. females, P = 0.57). EDV and ESV were unchanged over time. The MLHFQ score, New York Heart Association (NYHA) class, endothelial progenitor cell-colony forming units, and serum tumour necrosis factor alpha improved similarly in both groups.Conclusion Despite major differences in phenotypic presentation of NIDCM in males and females, this study is the first of its kind to demonstrate that MSC therapy improves a variety of parameters in NIDCM irrespective of patient sex. These findings have important clinical and pathophysiologic implications regarding the impact of sex on responses to cell-based therapy for NIDCM.[GRAPHICS].