The ABCD (Autologous Bone Marrow Cells in Dilated Cardiomyopathy) Trial

Seth, Sandeep; Bhargava, Balram; Narang, Rajiv; Ray, Ruma; Mohanty, Sujata; Gulati, Gurpreet Singh; Kumar, Lalit; Airan, Balram; Venugopal, Panangipalli

doi:10.1016/j.jacc.2009.11.070

Cited by 88 publications

(84 citation statements)

References 2 publications

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“…These findings are similar to a number of other studies that showed that the clinical benefits of cell therapy were sustained with BMSC. 16,27,32) However, a significant decrease in LVEF was observed in the BMMC group in comparison with the values at the 3-month follow-up, in accordance with the BOOST trial, in which patients received BMMC or conventional therapy and which demonstrated that cardiac performance improved significantly in the cell therapy group at a 6-month follow-up, 6) whereas the benefit was not observed at 18 months following administration. 33) The temporal changes in improvement in LVEF and NYHA class suggested that BMMC transplantation only accelerates cardiac function recovery and that most of the beneficial effects are observed soon after stem cell delivery.…”

Section: Discussionsupporting

confidence: 81%

“…Because severely reduced coronary flow reserve and impaired microvascular function are implicated in the pathogenesis and prognosis of nonischemic DCM, 9,10) Seth, et al 4) performed the first clinical study of intracoronary stem cell injection in patients with DCM and confirmed that cell therapy was safe and effective. Since the pioneering work of Seth, et al 4,27) many groups have performed clinical trials and confirmed the effectiveness of this new therapy, 11,14) although these results have been disputed. 12,13) However, different stem cell subpopulations have different characteristics and plasticity: BMMC integrate almost all the BMC characteristics, can be easily harvested and manipulated, and are the cell type most studied and used in the clinical setting.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A Randomized Comparative Study on the Efficacy of Intracoronary Infusion of Autologous Bone Marrow Mononuclear Cells and Mesenchymal Stem Cells in Patients With Dilated Cardiomyopathy

et al. 2017

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SummaryStem cell therapy has shown therapeutic benefit in dilated cardiomyopathy (DCM), but doubt remains about the most appropriate stem cell subpopulation. The current study compared the efficacy of intracoronary administration of bone marrow mononuclear cells (BMMC) or mesenchymal stem cells (BMSC) in patients with DCM.Fifty-three patients with DCM and reduced (< 40%) left ventricular ejection fraction (LVEF), were randomized to intracoronary infusion of BMMC (BMMC group, n = 16) or BMSC (BMSC group, n = 17) or equal volume normal saline (CTRL group, n = 20). LVEF, New York Heart Association (NYHA) class, left ventricular end-diastolic diameter (LVEDd), and myocardial perfusion were assessed at baseline and at 3-month and 12-month follow-ups. Major adverse cardiovascular events (MACE) were also recorded.At the 3-month follow-up, LVEF, NYHA class, and myocardial perfusion had improved significantly in the BMSC group (P = 0.004, 0.020 and 0.019, respectively) along with significant changes in LVEF and NYHA class in the BMMC group compared with CTRL (P = 0.042 and 0.047, respectively), however, LVEDd remained unchanged. In comparison with CTRL, LVEF, NYHA class, and myocardial perfusion improved significantly in the BMSC group at the 12-month follow-up (P = 0.005, 0.050 and 0.038 respectively), but not in the BMMC group (P > 0.05). There were no significant differences between the transplantation groups during follow-up (P > 0.05). There were no differences in MACE among the 3 groups (P = 0.817).Intracoronary bone marrow stem cell transplantation in DCM is safe and effective, while BMSC and BMMC infusion possess comparable effectiveness. (Int Heart J 2017; 58: 238-244) Key words: Heart failure, Therapeutics, Cytological techniques, Transplantation D ilated cardiomyopathy (DCM), characterized by ventricular dilatation and impaired systolic function of the left or both ventricles of incompletely understood pathogenesis, is the most common form of non-ischemic cardiomyopathy.1,2) Current therapies for the condition, such as beta-blockers, angiotensin-converting enzyme inhibitors (ACEI), angiotensin receptor antagonists (ARBs), and mechanotherapy seek to reduce the rate at which myocardial damage accrues but do not have regenerative potential. Thus, new therapeutic procedures for this condition are required for this significant, unmet clinical need.The exploration and development of regenerative treatment constitutes a promising therapeutic option for nonischemic cardiomyopathy.3,4) Intracoronary administration of autologous bone marrow stem cells (BMC) has proved to be safe and has shown significant improvement of cardiac function in the treatment of post-infarct and chronic ischemic models in both preclinical and clinical settings. [5][6][7][8] Because severely reduced coronary flow reserve and impaired microvascular function have been observed in patients with DCM, 9,10) several clinical studies have applied cell therapy to these patients, 4,[11][12][13][14] despite much controversy concerning the underlying mech...

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

A Randomized Comparative Study on the Efficacy of Intracoronary Infusion of Autologous Bone Marrow Mononuclear Cells and Mesenchymal Stem Cells in Patients With Dilated Cardiomyopathy

et al. 2017

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“…41 In accordance with these findings, the ABCD trial demonstrated an improvement in ejection fraction and quality of life during a mean follow-up of 4 years. 42 Similarly, evaluations after the first month in patients with end-stage nonischemic heart failure who received bone-marrow stem cell infusions showed improvements in ejection fraction, peak VO 2 , NYHA functional class, and quality of life. 43 In a pilot randomized study, our team of researchers from Ljubljana University Medical Center, Stanford University School of Medicine, and the Methodist DeBakey Heart & Vascular Center found that intracoronary bone-marrow stem cell transplantation could indeed lead to improved ventricular remodeling, better exercise tolerance, and potentially improved survival in these patients.…”

Section: Clinical Effects Of Stem Cell Therapy In Nonischemic Heart Fmentioning

confidence: 92%

Stem Cell Therapy in Patients with Heart Failure

Vrtovec¹,

Poglajen²,

Haddad³

2013

Methodist DeBakey Cardiovascular Journal

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“…En pacientes con miocardiopatía de etiología no isquémica, existe una experiencia más reducida [68][69][70][71][72][73][74][75] . El ensayo aleatorizado ABCD señaló un aumento significativo y persistente de la FEVI y mejora en la calidad de vida en pacientes con cardiopatía dilatada, tratados con BMMC autólogas en su seguimiento a 3 años 72 . Otro estudio aleatorizado recientemente publicado, también reveló un aumento persistente de la FEVI, así como una reducción significativa de la morbimortalidad en pacientes tratados con células BMMC autólogas, a 60 meses 74 .…”

Section: Terapia Celular En Cardiopatías Crónicasunclassified