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自体骨骼肌成肌细胞片(TCD - 51073)治疗缺血性心脏病所致严重慢性心力衰竭的安全性和有效性

Safety and Efficacy of Autologous Skeletal Myoblast Sheets (TCD-51073) for the Treatment of Severe Chronic Heart Failure Due to Ischemic Heart Disease.

作者信息

Sawa Yoshiki, Yoshikawa Yasushi, Toda Koichi, Fukushima Satsuki, Yamazaki Kenji, Ono Minoru, Sakata Yasushi, Hagiwara Nobuhisa, Kinugawa Koichiro, Miyagawa Shigeru

机构信息

Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine.

出版信息

Circ J. 2015;79(5):991-9. doi: 10.1253/circj.CJ-15-0243.

Abstract

BACKGROUND

Poor survival outcomes for patients with severe heart failure (HF) and the donor shortage for heart transplantation warrant the development of myocardial regenerative therapy. We performed a multicenter, phase II study to evaluate the safety and efficacy of autologous skeletal myoblast sheets (TCD-51073).

METHODS AND RESULTS

In 3 study sites, we enrolled 7 patients with severe chronic HF due to ischemic heart disease despite maximal therapy, all of whom underwent transplantation of TCD-51073. No serious arrhythmia was reported, and no changes were noted in the frequency of ventricular extrasystole frequency. The primary efficacy endpoint of the change in left ventricular ejection fraction (LVEF) on gated blood-pool scintigraphy at 26 weeks after transplantation showed that 5 subjects were responders (classified as "improved" or "unchanged"). In addition, LVEF on echocardiography improved over time, with a change in LVEF of 7.1±2.8% at 26 weeks posttransplantation. Among the 7 subjects, 6 showed improvement in New York Heart Association functional class by at least 1 class. The 6-min walk distance was 410.1±136.1 m before transplantation and 455.4±103.7 m at 26 weeks after transplantation.

CONCLUSIONS

This study demonstrated the feasibility and safety of the transplantation of TCD-51073 in the patients with severe chronic HF due to ischemic heart disease, suggesting that TCD-51073 might maintain or improve cardiac function, symptoms, and physical function.

摘要

背景

重度心力衰竭(HF)患者的生存结局较差,且心脏移植供体短缺,这使得心肌再生治疗的发展成为必要。我们开展了一项多中心II期研究,以评估自体骨骼肌成肌细胞片(TCD - 51073)的安全性和有效性。

方法与结果

在3个研究地点,我们纳入了7例尽管接受了最大程度治疗但仍因缺血性心脏病导致重度慢性HF的患者,所有患者均接受了TCD - 51073移植。未报告严重心律失常,室性早搏频率也未发生变化。移植后26周时,门控心血池闪烁显像术测定的左心室射血分数(LVEF)变化这一主要疗效终点显示,5名受试者为反应者(分类为“改善”或“未改变”)。此外,超声心动图测定的LVEF随时间改善,移植后26周时LVEF变化为7.1±2.8%。在这7名受试者中,6名纽约心脏协会功能分级至少改善了1级。6分钟步行距离在移植前为410.1±136.1米,移植后26周时为455.4±103.7米。

结论

本研究证明了TCD - 51073移植在因缺血性心脏病导致重度慢性HF患者中的可行性和安全性,表明TCD - 51073可能维持或改善心脏功能、症状和身体功能。

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