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[A prospective, randomized, controlled trial of autologous mesenchymal stem cells transplantation for dilated cardiomyopathy].

OBJECTIVE
Recent experimental and clinical observations have suggested that cell transplantation could be of therapeutic value for the treatment of heart failure. This study was performed to explore the efficacy and safety of intracoronary autologous mesenchymal stem cells (MSCs) transplantation for treating patients with idiopathic dilated cardiomyopathy.


METHOD
Twenty-four consecutive patients with idiopathic dilated cardiomyopathy received standard drug therapy were randomly divided into intracoronary injection of autologous mesenchymal stem cells (treated, n = 12) or saline (control, n = 12) groups. Serum IL-6, TNF-alpha and CRP, plasma brain natriuretic peptides (BNP) were determined and echocardiography, Holter electrocardiogram monitoring and six minutes walk test were performed at baseline, 3 and 6 months post injection.


RESULTS
IL-6, TNF-alpha and CRP remained unchanged after MSCs transplantation. Plasma BNP levels at 3 months and 6 months post MSCs injection were significantly higher than that of pre-injection (378.10 +/- 147.47, 420.40 +/- 148.50 vs. 292.40 +/- 148.54 ng/L, respectively, P < 0.05) but were significantly lower than that in control group at comparable time points (3 months: 378.10 +/- 147.47 vs. 473.10 +/- 106.31 ng/L; 6 months: 420.40 +/- 148.50 vs. 544.60 +/- 93.11 ng/L, P < 0.05). Six-minute-walking distance significantly increased at 6 months after MSCs injection compared with pre-injection level and which is also higher than that in control patients (519.00 +/- 43.28 vs. 396.33 +/- 42.19 and 464.00 +/- 76.5 m, respectively, P < 0.05). Left ventricular ejection fraction and LVEDd remained unchanged post MSCs injection. No malignant arrhythmias and severe side effects could be observed around transplantation and during six months follow-up. Survival was similar between the two groups during six months follow-up.


CONCLUSION
Percutaneous coronary autologous mesenchymal stem cells transplantation can attenuate the increase of plasma BNP, increase six-minute-walking capacity in patients with idiopathic dilated cardiomyopathy.