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Impact of intracoronary reinfusion of bone marrow-derived mononuclear progenitor cells on cardiopulmonary exercise capacity in patients with chronic postinfarction heart failure

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Abstract

Introduction

Intracoronary infusion of bone marrow-derived progenitor cells (BMC) in patients with chronic ischaemic heart failure (CHF) is associated with improvement in left ventricular ejection fraction (LVEF), reduction of NT-proBNP levels and improved prognosis. However, effects of this therapy on cardiopulmonary exercise capacity have not been investigated separately so far.

Patients and methods

One hundred and fifty-four patients with ischaemic heart failure (mean LVEF 40.3 ± 10.9 %, NT-proBNP 1,103 ± 1,436 pg/ml) underwent cardiopulmonary exercise capacity testing (CPX) before and 3 months after intracoronary infusion of autologous BMC. Thirty patients with a potential bias on the CPX course as concomitant coronary intervention, bypass surgery, new onset of arrhythmias or implantation of cardiac resynchronization devices were excluded from further analysis.

Results

The remaining 124 patients showed an increase in exercise time and peak workload by 16.8 and 6 %. Peak oxygen uptake and oxygen uptake efficiency slope also improved by 2.9 and 12.9 %, whereas other parameters like peak oxygen pulse and the slope of minute ventilation versus CO2 elimination remained unchanged. Analysis of patients with poor, moderate and conserved CPX results prior to cell therapy documented that patients in tertiles with lowest initial exercise capacity showed the largest improvements in CPX after therapy. The differences in response to cell therapy were detectable in all investigated CPX parameters and became significant for exercise time, peak oxygen uptake and peak oxygen pulse.

Summary

These findings indicate that intracoronary BMC therapy improves exercise capacity in CHF patients with more advanced heart failure.

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Acknowledgments

We gratefully acknowledge the help and support of our study nurses Stephanie Estel, Daniela Hoehl and Isabel Geweyer.

Conflict of interest

Drs. Stefanie Dimmeler and Andreas Zeiher report that they are cofounders of t2cure, a for-profit company focused on regenerative therapies for cardiovascular disease. They serve as scientific advisers and are shareholders. There are no other conflicts of interest.

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Authors and Affiliations

  1. Medizinische Klinik III/Kardiologie, Klinikum Goethe-Universität, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany

    Joerg Honold, Ulrich Fischer-Rasokat, Florian H. Seeger, David Leistner, Saskia Lotz, Andreas M. Zeiher & Birgit Assmus

  2. Institute of Cardiovascular Regeneration, Center for Molecular Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany

    Stefanie Dimmeler

Authors
  1. Joerg Honold
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  2. Ulrich Fischer-Rasokat
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  3. Florian H. Seeger
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  4. David Leistner
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  5. Saskia Lotz
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  8. Birgit Assmus
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Correspondence to Birgit Assmus.

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Honold, J., Fischer-Rasokat, U., Seeger, F.H. et al. Impact of intracoronary reinfusion of bone marrow-derived mononuclear progenitor cells on cardiopulmonary exercise capacity in patients with chronic postinfarction heart failure. Clin Res Cardiol 102, 619–625 (2013). https://doi.org/10.1007/s00392-013-0574-1

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  • DOI: https://doi.org/10.1007/s00392-013-0574-1

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