Kayleigh Hunt and Alexa Maziuk
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
Abby Massey, MD
Date of Graduation
To assess the efficacy of stem cells in the improvement of functional capacity and quality of life in the setting of nonischemic dilated cardiomyopathy.
Systematic literature review
A literature search of PubMed was conducted utilizing the following search terms: “stem,” “cell,” “nonischemic,” and “cardiomyopathy.” The following limits were used: “2015-2018,” nonischemic cardiomyopathy, results of LVEF and 6MWT, randomized controlled trials, pilot studies, and sample size >22.
Butler et al. found that within the itMSC group, 6MWD increased by an average of 27.40 m (95% CI 0.28–54.52; P=0.05), but it decreased by an average of 10.83 m (95% CI −38.66 to 17.00, P=0.45) among control patients. The authors used exploratory analyses to examine changes from baseline after initial randomization and found significant increases in LVEF in the itMSC group (estimated mean difference was +2.31; P=0.02) with no significant changes in control group (+1.62; P=0.13.). Vrtovec et al. revealed improvement in LVEF and 6MWT in both single and repetitive dose groups (group A and group B), when comparing each group separately from baseline to 6 months (LVEF: +6.9±3.3% in group A, P=0.001 and +7.1±3.5% in group B, P=0.001; 6MWT: +87±21 m, P=0.03 and +92±25 m, P=0.02). Hare et al. found that at 12 months post-treatment, LVEF increased in the allo-hMSC group by 8.0% (CI: 2.8% to 13.2%, p = 0.004) compared to baseline which was found to be statistically significant, but the LVEF increase of 5.4% in the auto-hMSC group was not statistically significant (CI: -1.4% to 12.1%; p = 0.116). At 12 months post-treatment, the 6MWT distance significantly increased in the allo-hMSC treatment group by 37.0 meters (CI: 2.0m to 72.0m, p = 0.04) compared to baseline. At 12 months post-treatment, the auto-hMSC treatment group 6MWT distance increased 7.3 meters compared to baseline and was not statistically significant (CI: -47.8m to 33.3m, p = 0.71).
Stem cell therapy is shown to be safe, well-tolerated, and effective in improving functional capacity, quality of life, and short-term event survival in patients with nonischemic cardiomyopathy and, thus, is a promising alternative therapeutic option for patients with nonischemic cardiomyopathy and should be further explored in future studies.
Hunt KE, Maziuk AE. Effects of Stem Cell Therapy on 6-Minute Walk Test Distance and Left Ventricular Ejection Fraction in Patients with Nonischemic Cardiomyopathy. JMU Scholarly Commons Physician Assistant Capstones. https://commons.lib.jmu.edu/pacapstones. Published December 11, 2019.