Impact of Cardiac Progenitor Cells on Heart Failure and Survival in Single Ventricle Congenital Heart Disease
Impact of Cardiac Progenitor Cells on Heart Failure and Survival in Single Ventricle Congenital Heart Disease
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DOI：
10.1161/circresaha.117.312311
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发表时间：
2018-03-30
影响因子：
20.1
通讯作者：
Oh, Hidemasa
中科院分区：
文献类型：
--
作者：
Sano, Toshikazu;Ousaka, Daiki;Oh, Hidemasa
理由：单心室患者冠状动脉内给予心球源性细胞（cdc）可短期改善心功能。目的：验证CDC输注与心力衰竭患者心功能改善和死亡率降低相关的假设。方法和结果：我们对101例单心室患者进行了一项综合队列研究，评估了CDC的有效性，其中包括41例接受CDC输注的患者和60例单独接受分阶段姑息治疗的对照组。心衰伴射血分数保留（EF）或降低（EF）按手术重建后心功能分层。主要结局指标是评估2年时心功能改善的程度和全因死亡率。动物研究旨在阐明EF保留型心力衰竭和EF减少型心力衰竭的潜在机制。2年后，CDC输注增加了心室功能（2期：+8.410.0% vs +1.66.4%， P=0.03； 3期：+7.9 +/- 7.5% vs -1.1 +/- 5.5%， P=0.03）
Rationale: Intracoronary administration of cardiosphere-derived cells (CDCs) in patients with single ventricles resulted in a short-term improvement in cardiac function.Objective: To test the hypothesis that CDC infusion is associated with improved cardiac function and reduced mortality in patients with heart failure.Methods and Results: We evaluated the effectiveness of CDCs using an integrated cohort study in 101 patients with single ventricles, including 41 patients who received CDC infusion and 60 controls treated with staged palliation alone. Heart failure with preserved ejection fraction (EF) or reduced EF was stratified by the cardiac function after surgical reconstruction. The main outcome measure was to evaluate the magnitude of improvement in cardiac function and all-cause mortality at 2 years. Animal studies were conducted to clarify the underlying mechanisms of heart failure with preserved EF and heart failure with reduced EF phenotypes. At 2 years, CDC infusion increased ventricular function (stage 2: +8.410.0% versus +1.66.4%, P=0.03; stage 3: +7.9 +/- 7.5% versus -1.1 +/- 5.5%, P