Krishna Mohan Gautham Varun, Tirumandyam Gayathri, Vemulapalli Hema Srikanth, Vajje Jaahnavi, Asif Hamza, Saleem Faraz
Internal Medicine, Tirunelveli Medical College, Tirunelveli, IND.
Internal Medicine, Siddhartha Medical College, Dr. YSR University of Health Sciences, Vijayawada, IND.
Cureus. 2023 Aug 6;15(8):e43037. doi: 10.7759/cureus.43037. eCollection 2023 Aug.
Mesenchymal stem cell (MSC) therapy is a frequently used treatment option for achieving a better prognosis in patients with heart failure (HF). However, due to reported adverse effects, patients are often hesitant to consider this treatment. Consequently, the aim of this systemic review and meta-analysis is to further investigate the effects of MSCs on survival outcomes, hospital readmissions, and left ventricular ejection fraction (LVEF) in individuals with pre-existing HF. We systematically searched PubMed, Web of Science, Embase, and Cochrane Library to review studies published up until July 16, 2023. Risk ratios were generated using the extracted data for all the outcomes except LVEF. The mean difference was generated for LVEF. Sensitivity analysis was performed to investigate heterogeneity, and the risk of bias tool was used to assess the quality of the included studies. Fourteen randomized controlled trials were included in the meta-analysis. Pooled results revealed that the MSC therapy group did not significantly affect the outcomes of cardiovascular death, rehospitalization rate, myocardial infarction, recurrence of HF, and total death when compared to a control group. However, MSC therapy was significantly associated with an increased LVEF (RR = 3.35; 95% CI: 0.79-5.72; p = 0.010; I2 = 95%). Upon sensitivity analysis, MSC therapy was significantly associated with a decreased hospitalization rate (RR = 0.46; 95% CI: 0.34-0.64; p < 0.00001; I2 = 0%). MSC transplantation results in a significantly improved LVEF and rehospitalization rate.
间充质干细胞（MSC）疗法是心力衰竭（HF）患者改善预后常用的治疗选择。然而，由于有不良反应的报道，患者往往对这种治疗犹豫不决。因此，本系统评价和荟萃分析的目的是进一步研究MSC对已有HF患者生存结局、再次入院率和左心室射血分数（LVEF）的影响。我们系统检索了PubMed、科学网、Embase和Cochrane图书馆，以回顾截至2023年7月16日发表的研究。除LVEF外，所有结局均使用提取的数据生成风险比。LVEF生成平均差。进行敏感性分析以研究异质性，并使用偏倚风险工具评估纳入研究的质量。荟萃分析纳入了14项随机对照试验。汇总结果显示，与对照组相比，MSC治疗组对心血管死亡、再住院率、心肌梗死、HF复发和总死亡结局没有显著影响。然而，MSC治疗与LVEF增加显著相关（RR = 3.35；95%CI：0.79 - 5.72；p = 0.010；I² = 95%）。经敏感性分析，MSC治疗与住院率降低显著相关（RR = 0.46；95%CI：0.34 - 0.64；p < 0.00001；I² = 0%）。MSC移植可显著改善LVEF和再住院率。
