Midterm Results of Surgical Intramyocardial Implantation of Autologous Angiogenic Cell Precursors for Cardiomyopathy

Abstract

C ardiomyopathies are primary (i.e., genetic, mixed, or acquired) or secondary (e.g., infiltrative, toxic, inflammatory) and lead to progressive heart failure with significant morbidity and mortality. 1 Dilated cardiomyopathy (DCM) is classified as a mixed (genetic and nongenetic) primary cardiomyopathy. DCM manifests clinically at a wide range of ages and is characterized by ventricular chamber enlargement and systolic dysfunction which leads to progressive heart failure and a decline in left ventricular function, ventricular and supraventricular arrhythmias, conduction system abnormalities, thromboembolism, and sudden or heart failure-related death. Indeed, DCM is a common and largely irreversible form of heart muscle disease. It is the most frequent cause of heart transplantation. Coronary artery disease is one of the most frequent causes of heart failure (HF). There is no uniform definition for ischemic cardiomyopathy (ICM). Despite improvements with medical treatment, the prognosis of patients with end-stage HF remains poor. The median survival was 4 years after the onset of HF. One-year survival was 72% and 5-year survival was 45% after the onset of HF. 2 Revascularization of nonviable myocardium has not proven to be beneficial in terms of either mortality or improvement of left ventricular function. Heart transplantation is currently the best treatment option for end-stage cardiomyopathy however it is limited by a shortage of donors. In this study, we only included patients with DCM and ICM.