Toronto, ON - A randomized trial of autologous adult stem-cell transplantation for the treatment of congestive heart failure has shown an improvement in cardiac function. "Patients who received stem cells decreased functional class by almost two," lead researcher Dr Amit Patel (University of Pittsburgh School of Medicine, PA) told heartwire. He explained that in many cases, patients with severe heart failure, defined as NYHA heart failure class 3 or 4, dropped down to class 1 or 2. Results of the study were presented April 25 at the annual meeting of the American Association for Thoracic Surgery.

Patel noted that autologous adult stem-cell transplantation has been used to treat many diseases, but its use in cardiovascular disease has been performed only recently. In this study, the novel epicardial technique to deploy stem cells was compared with conventional therapy.

Patel and colleagues performed adult autologous stem-cell transplantations in patients with coronary artery disease who had an ejection fraction <35% and who were undergoing primary off-pump CABG. Using bone marrow from the patient's hipbone, the team extracted CD34+ and CD45- cells. "This was a truly one-step process," Patel said. "The harvesting and therapy were all done with one anesthetic."

The research team prospectively randomized the patients before operative treatment. Patients were given an echocardiogram and underwent stress thallium imaging single-photon-emission computed tomography (SPECT) and a cardiac catheterization before surgery. These imaging modalities were used to identify ischemic regions of the heart and to guide in mapping for injection of the stem cells.