Abstract

AIMS: We investigated the effects of CD34+ cell therapy in patients with heart failure with preserved ejection fraction (HFpEF).METHODS AND RESULTS: In a prospective pilot study, we enrolled 30 patients with HFpEF. In Phase 1, patients were treated with medical therapy for 6 months. Thereafter, all patients underwent CD34+ cell transplantation. Using electroanatomical mapping, we measured local mechanical diastolic delay and myocardial viability to guide the targeting of cell injections. Patients were followed for 6 months after cell transplantation (Phase 2), and the primary end-point was the difference in change in E/e' between Phase 1 and Phase 2. In Phase 1, the decrease in E/e' was significantly less pronounced than in Phase 2. (-0.33±1.72 vs. -3.77±2.66, P=0.001). During Phase 1, there was no significant change in global systolic strain (GLS; from -12.5±2.4% to -12.8±2.6%, P=0.77), NT-proBNP (from 1463±1247 pg/mL to 1298±931 pg/mL, P=0.31), or 6-minute walk test distance (6MWT; from 391±75 m to 402±93 m, P=0.42). In Phase 2, an improvement was noted in NT-proBNP (from 1298±931 pg/ml to 887±809 pg/ml, P=0.02) and 6MWT (from 402±93 m to 438±72 m, P=0.02). Although GLS did not change significantly in Phase 2 (from -12.8±2.6% to -13.8±2.7%, P=0.36), we found improved local systolic strain at cell injection sites (-3.4±6.8%, P=0.005).CONCLUSIONS: In this non-randomized trial, transendocardial CD34+ cell therapy in HFpEF was associated with an improvement in E/e', NT-proBNP, exercise capacity, and local myocardial strain at the cell injection sites.CLINICAL TRIALS REGISTRATION: Clinicaltrials.gov NCT02923609 This article is protected by copyright. All rights reserved.

View details for DOI 10.1002/ejhf.2596

View details for PubMedID 35775390