Patel AN et al. (2005) Surgical treatment for congestive heart failure with autologous adult stem cell transplantation: a prospective randomized study. J Thorac Cardiovasc Surg 130: 1631–1638

Congestive heart failure (CHF) is an important global health problem. This condition arises from myocardial dysfunction and prevents the heart from circulating sufficient blood to sustain the metabolic requirements of the body. Patel and co-workers hypothesized that autologous stem-cell transplantation to ischemic regions of the heart could regenerate cardiac myocytes and stimulate neovascularization, to restore myocardium viability and improve cardiac function, in patients undergoing off-pump coronary artery bypass grafting (OPCABG) for ischemic cardiomyopathy.

In this investigation, 20 patients with ischemic CHF requiring revascularization were prospectively randomized to undergo primary OPCABG with or without concurrent stem-cell transplantation (10 patients per group). Left ventricular ejection fraction measurements were similar in the two groups at baseline. Following surgery, patients in the stem-cell-transplantation group had higher ejection fractions than those in the non-stem-cell-transplantation group (P <0.01 at each time point measured—1, 3 and 6 months).

Future studies are required to show how the cell type, harvest and implantation techniques affect the clinical success of transplantation. Whether differences arise between patients who undergo OPCABG and on-pump CABG, related to inflammatory responses to bypass, might also be useful to investigate. In this study, however, autologous stem-cell transplantation significantly improved cardiac function in CHF patients undergoing OPCABG.