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Gwizdala A, Rozwadowska N, Kolanowski TJ, Malcher A, Cieplucha A, Perek B, Seniuk W, Straburzynska-Migaj E, Oko-Sarnowska Z, Cholewinski W, Michalak M, Grajek S, Kurpisz M. Safety, feasibility and effectiveness of first in-human administration of muscle-derived stem/progenitor cells modified with connexin-43 gene for treatment of advanced chronic heart failure. Eur J Heart Fail 2017; 19:148-157. [PMID: 28052545 DOI: 10.1002/ejhf.700] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 09/29/2016] [Accepted: 11/02/2016] [Indexed: 12/22/2022] Open
Abstract
AIMS To assess the safety and efficacy of transendocardial delivery of muscle-derived stem/progenitor cells with connexin-43 overexpression (Cx-43-MDS/PC) in advanced heart failure (HF). METHODS AND RESULTS Thirteen subjects with advanced HF, New York Heart Association (NYHA) class II-III were enrolled and treated with targeted injection of Cx-43-MDS/PCs and then monitored for at least 6 months. Overexpression of Cx43 (Cx43+) was significantly higher in all but one subject (Cx43-). Injection of MDS/PCs was associated with significant improvement of exercise capacity: NYHA (3 ± 0 vs. 1.8 ± 0.7, P = 0.003), exercise duration (388.69 ± 141.83 s vs. 462.08 ± 176.69 s, P = 0.025), peak oxygen consumption (14.38 ± 3.97 vs. 15.83 ± 3.74 ml/kg.min, P = 0.022) and oxygen pulse (10.58 ± 2.89 vs. 18.88 ± 22.63 mLO2 /heart rate, P = 0.012). Levels of BNP, left ventricular (LV) ejection fraction and LV end-diastolic volumes tended to improve. There was a significant improvement of the mean unipolar voltage amplitudes measured for the injected segments and the entire left ventricle (9.62 ± 2.64 vs. 11.62 ± 3.50 mV, P = 0.014 and 8.83 ± 2.80 vs. 10.22 ± 3.41 mV, P = 0.041, respectively). No deaths were documented, Cx43+ (n = 12) subjects presented no significant ventricular arrhythmia; one Cx43- subject suffered from ventricular tachycardia (successfully treated with amiodarone). CONCLUSIONS Injection of Cx-43-MDS/PCs in patients with severe HF led to significant improvement in exercise capacity and myocardial viability of the injected segments while inducing no significant ventricular arrhythmia. This may arise from improved electrical coupling of the injected cells and injured myocardium and thus better in-situ mechanical cooperation of both cell types. Therefore, further clinical studies with Cx43+ MDS/PCs are warranted.
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Affiliation(s)
- Adrian Gwizdala
- Poznan University of Medical Sciences, 1st Department of Cardiology, Poznan, Poland
| | - Natalia Rozwadowska
- Department of Reproductive Biology and Stem Cells, Institute of Human Genetics Polish Academy of Sciences, ul. Strzeszynska 32, 60-479, Poznan, Poland
| | - Tomasz Jan Kolanowski
- Department of Reproductive Biology and Stem Cells, Institute of Human Genetics Polish Academy of Sciences, ul. Strzeszynska 32, 60-479, Poznan, Poland
| | - Agnieszka Malcher
- Department of Reproductive Biology and Stem Cells, Institute of Human Genetics Polish Academy of Sciences, ul. Strzeszynska 32, 60-479, Poznan, Poland
| | - Aleksandra Cieplucha
- Poznan University of Medical Sciences, 1st Department of Cardiology, Poznan, Poland
| | - Bartlomiej Perek
- Poznan University of Medical Sciences, Department of Cardiac Surgery, Poznan, Poland
| | - Wojciech Seniuk
- Poznan University of Medical Sciences, 1st Department of Cardiology, Poznan, Poland
| | | | - Zofia Oko-Sarnowska
- Poznan University of Medical Sciences, 1st Department of Cardiology, Poznan, Poland
| | - Witold Cholewinski
- Greater Poland Cancer Centre, Nuclear Medicine Department, Poznan, Poland
| | - Michal Michalak
- Poznan University of Medical Sciences, Department of Statistics, Poznan, Poland
| | - Stefan Grajek
- Poznan University of Medical Sciences, 1st Department of Cardiology, Poznan, Poland
| | - Maciej Kurpisz
- Department of Reproductive Biology and Stem Cells, Institute of Human Genetics Polish Academy of Sciences, ul. Strzeszynska 32, 60-479, Poznan, Poland
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