TY - JOUR
T1 - Combined transepicardial and transseptal implantation of autologous CD 133+ bone marrow cells during bypass grafting improves cardiac function in patients with low ejection fraction
AU - Soetisna, Tri Wisesa
AU - Sukmawan, Renan
AU - Setianto, Budhi
AU - Mansyur, Muchtaruddin
AU - Murni, Tri Wahyu
AU - Listiyaningsih, Erlin
AU - Santoso, Anwar
N1 - Funding Information:
We extend our gratitude to Dr. Elen, Dr. Manoefris Kasim, and Dr. Habibie Arifianto for their contributions to interpreting the cardiac imaging. We thank Dr. Dicky Aligheri Wartono and Dr. Amin Tjubandi for their role in the surgical procedure. We also thank Dr. Christian, Dr. Erik Hoetama, Dr. Beta Canina Harlyjoy, Dr. Geswin Aditya Hermawan, Dr. Natasha Marianne Setiabakti, Dr. Maria Felinsianita, Dr. Stella Aprilia, and Dr. Florence Low for their assistance during this whole study. A professional native proofreader has reviewed this manuscript. This study was supported by a grant from National Cardiovascular Center Harapan Kita Hospital (Grant Number: LB.0101/VII/32/2016).
Publisher Copyright:
© 2020 The Authors. Journal of Cardiac Surgery Published by Wiley Periodicals, Inc.
PY - 2020/4/1
Y1 - 2020/4/1
N2 - Objectives: Autologous CD133+ bone marrow stem cells may improve cardiac function. This randomized, single-blind clinical trial inquired whether a combined transepicardial and transseptal implantation of CD133+ stem cells during coronary artery bypass grafting (CABG) improve cardiac function with ejection fraction (EF) changes as a primary endpoint in patients with low EF. Methods: Thirty patients with coronary heart disease and EF <35% were randomized to undergo CABG alone or CABG with transseptal and transepicardial implantation of CD133+. Cardiac function was evaluated using cardiac magnetic resonance imaging (MRI) before and 6 months after CABG. Results: Preoperative EF was lower in the intervention group (25.88% ± 5.66%) than in the control group (30.18% ± 3.85%; P =.04). The adverse event incidence was similar between both groups. At 6 months, EF changes were significantly higher (8.69% ± 9.49; P =.04) in the CD133+ group than in the CABG-only group. Compared to the control group, significant improvements were seen in the wall motion score index (P =.003) and scar size proportion (P =.047) in the CD133+ group. The quality of life (QOL), assessed by a 6-minute walking test, showed considerable improvement in the CD133+ group compared to that in the control group (P =.03). The Minnesota Living with Heart Failure Questionnaire (MLHFQ) scale did not show improvement in the intervention group (P =.09, vs control). Conclusion: Combined transepicardial and transseptal autologous CD133+ BMC implantation during bypass grafting improved cardiac function in low EF coronary artery disease patients.
AB - Objectives: Autologous CD133+ bone marrow stem cells may improve cardiac function. This randomized, single-blind clinical trial inquired whether a combined transepicardial and transseptal implantation of CD133+ stem cells during coronary artery bypass grafting (CABG) improve cardiac function with ejection fraction (EF) changes as a primary endpoint in patients with low EF. Methods: Thirty patients with coronary heart disease and EF <35% were randomized to undergo CABG alone or CABG with transseptal and transepicardial implantation of CD133+. Cardiac function was evaluated using cardiac magnetic resonance imaging (MRI) before and 6 months after CABG. Results: Preoperative EF was lower in the intervention group (25.88% ± 5.66%) than in the control group (30.18% ± 3.85%; P =.04). The adverse event incidence was similar between both groups. At 6 months, EF changes were significantly higher (8.69% ± 9.49; P =.04) in the CD133+ group than in the CABG-only group. Compared to the control group, significant improvements were seen in the wall motion score index (P =.003) and scar size proportion (P =.047) in the CD133+ group. The quality of life (QOL), assessed by a 6-minute walking test, showed considerable improvement in the CD133+ group compared to that in the control group (P =.03). The Minnesota Living with Heart Failure Questionnaire (MLHFQ) scale did not show improvement in the intervention group (P =.09, vs control). Conclusion: Combined transepicardial and transseptal autologous CD133+ BMC implantation during bypass grafting improved cardiac function in low EF coronary artery disease patients.
KW - coronary artery bypass graft
KW - coronary artery disease
KW - heart failure
KW - stem cell
UR - http://www.scopus.com/inward/record.url?scp=85079427785&partnerID=8YFLogxK
U2 - 10.1111/jocs.14454
DO - 10.1111/jocs.14454
M3 - Article
C2 - 32048356
AN - SCOPUS:85079427785
VL - 35
SP - 740
EP - 746
JO - Journal of Cardiac Surgery
JF - Journal of Cardiac Surgery
SN - 0886-0440
IS - 4
ER -