Shock Waves Improve Coronary Stem Cell Treatment
Pretreatment before intracoronary cell infusion improves left ventricular ejection fraction
TUESDAY, April 16 (HealthDay News) -- In patients with chronic heart failure, cardiac shock wave pretreatment before intracoronary infusion of bone marrow-derived mononuclear cells (BMCs) significantly but modestly improves heart function, according to a study published in the April 17 issue of the Journal of the American Medical Association.
Birgit Assmus, M.D., from Goethe University in Frankfurt, Germany, and colleagues assigned 103 patients with chronic heart failure to cardiac shock wave treatment targeted to the left ventricular anterior wall, either low dose (42 patients), high dose (40 patients), or placebo (21 patients). After 24 hours, patients treated with shock waves were randomized to intracoronary infusion of BMCs or placebo, while the placebo group received intracoronary infusion of BMCs.
The researchers found that after four months the left ventricular ejection fraction significantly improved in the shock wave plus BMCs group compared with the shock wave plus placebo group (3.2 versus 1.0 percent). There was also significant improvement in regional wall thickening in the shock wave plus BMCs group compared with the shock wave plus placebo group (3.6 versus 0.5 percent). Major adverse cardiac events were significantly less common in the shock wave plus BMCs group compared with the other two groups (hazard ratio, 0.58).
"Among patients with post-infarction chronic heart failure, shock wave-facilitated intracoronary administration of BMCs versus shock wave treatment alone resulted in a significant, albeit modest, improvement in left ventricular ejection fraction at four months," Assmus and colleagues conclude.
The study was supported by t2cure. Two authors are founders of t2cure and two authors are employees of Dornier MedTech Systems. Several authors disclosed financial ties to the pharmaceutical industry.