Article
Stem-Cell Therapy Produces Ventricular Electrical Reverse Remodeling as Detected by BSPM in Patients with Refractory Heart Failure
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Published: | February 8, 2007 |
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Background: Stem-cell therapy is a novel and developing approach to treat patients with heart failure, acting by myocardial regeneration. The body surface potential mapping is capable of analyzing the activation in both ventricles, thus detecting improvements in myocardial performance.
Objective: To determine, using the body surface potential mapping, whether patients with heart failure have their ventricular electrical activation improved after undergoing stem-cell myocardial regeneration therapy.
Methods: Twenty patients (mean 50.4 +/- 15.2 years, 50% male) with left ventricular dysfunction, underwent body surface potential mapping examinations both before and after each cycle of stem-cell treatment (granulocyte-monocyte colony stimulating factor - monthly administration, determining stem-cell mobilization or mobilization associated to intracoronary infusion). The maps of isochronal lines built from the information acquired by the 87 leads of the body surface potential mapping equipment (58 leads on the anterior chest and 29 on the back) forwarded analysis of the global, right ventricular (RV) and left ventricular (LV) activation times (VAT). These were compared by paired t test before and after the first stem-cell injection, with a significance level established at P < 0.05.
Results: The body surface potential mapping analysis evidenced that the global VAT decreased by 4.3% after stem-cell injection (70.1ms +/- 8.4ms x 67.1ms +/- 8.6ms, P=0.047), owing exclusively to a significant 10.7% reduction of the right ventricular activation time (62.7ms +/- 13.9ms x 56.0ms +/- 10.8ms, p=0.017). No significant alteration of the left ventricular activation time was found (88.2ms +/- 12.2ms x 88.0ms +/- 16.6ms, p=NS).
Conclusion: The body surface potential mapping detected ventricular electrical reverse remodeling after stem-cell injection, owing to a decrease in the right ventricular activation time.