Chinese Journal of Tissue Engineering Research ›› 2017, Vol. 21 ›› Issue (5): 780-788.doi: 10.3969/j.issn.2095-4344.2017.05.021

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Safety and efficacy of autologous bone marrow mesenchymal stem cells for dilated cardiomyopathy: a Meta-analysis

Ai Jin-wei1, 2, 3, Liu Ying1, Liu Chu-fan1, Pei Bin1, 2, 3   

  1. 1Evidence-Based Medicine Center, 2Department of Biotherapy, 3Department of Orthopedics, Xiangyang Hospital, Hubei University of Medicine, Xiangyang 442000, Hubei Province, China
  • Online:2017-02-18 Published:2017-03-20
  • Contact: Pei Bin, Master’s supervisor, Chief physician, Professor, Evidence-Based Medicine Center, Xiangyang Hospital, Hubei University of Medicine, Xiangyang 442000, Hubei Province, China
  • About author:Ai Jin-wei, Master, Attending physician, Evidence-Based Medicine Center, Xiangyang Hospital, Hubei University of Medicine, Xiangyang 442000, Hubei Province, China Liu Ying, Master, Associate chief nurse, Evidence-Based Medicine Center, Xiangyang Hospital, Hubei University of Medicine, Xiangyang 442000, Hubei Province, China Ai Jin-wei and Liu Ying contributed equally to this work.
  • Supported by:

    the General Project for Western Medicine of Hubei Province in 2015-2016, No. WJ2015MB187; the Key Teaching and Research Project of Hubei University of Medicine, No. 2015025

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Abstract:

BACKGROUND: Autologous bone marrow mesenchymal stem cells (BMSCs) transplantation has been used for clinical treatment of dilated cardiomyopathy. But the efficacy and safety of autologous BMSCs transplantation remains controversial.
OBJECTIVE: To systematically assess the efficacy and safety of autologous BMSCs transplantation for treatment of dilated cardiomyopathy by using meta-analysis approach.
METHODS: PubMed, Cochrane Library (Issue 2, 2016), Embase, CNKI, CBM, VIP, WanFang were systemically searched for relevant randomized controlled trials (RCTs) about autologous BMSCs transplantation and conventional drugs for the treatment of dilated cardiomyopathy. After information extracting and quality assessing, Meta-analysis of left ventricular ejection fraction, left ventricular end-diastolic diameter, 6-minute walking distance, percentage of myocardial perfusion defect, mortality, incidence of malignant arrhythmia events and heart transplantation rate during treatment and follow-up was performed using R3.1.0 software.
RESULTS AND CONCLUSION: A total of 7 RCTs involving 341 patients were included. Meta-analysis results showed that for efficacy, compared with the conventional drugs, BMSCs can increase the left ventricular ejection fraction [1 month post-treatment: mean difference (MD)=3.02, 95% confidence interval (CI) (1.55, 4.49); 3 months post-treatment: MD=4.38, 95%CI(3.55, 5.52); 6 months post-treatment: MD=6.47, 95%CI(4.78, 8.15); ≥ 12 months post-treatment: MD=8.23, 95%CI(5.15, 9.19)]; decrease the left ventricular end-diastolic diameter after 3 months [3 months post-treatment: MD=-0.65, 95%CI(-0.72, -0.59); 6 months post-treatment: MD=-0.12, 95%CI(-0.21, -0.03); ≥ 12 months post-treatment: MD=-0.19, 95%CI(-0.24, -0.13)]; increase 6-minute walking distance after 6 months [6 months post-treatment: MD=87.70, 95%CI(51.55, 123.85); ≥ 12 months post-treatment: MD=143.83, 95%CI(122.73, 164.93)]; and decrease percentage of myocardial perfusion defect at 3 months [MD=-3.56, 95%CI(-5.57, -1.55)]. For safety, BMSCs can decrease the mortality [risk ratio=0.46, 95%CI(0.24, 0.89)], but there is no significant difference in the incidence of malignant arrhythmia events and heart transplantation rate between two treatment groups. To conclude, these results indicate that BMSCs transplantation for dilated cardiomyopathy is one of effective and safe treatments.

 

中国组织工程研究杂志出版内容重点：干细胞；骨髓干细胞；造血干细胞；脂肪干细胞；肿瘤干细胞；胚胎干细胞；脐带脐血干细胞；干细胞诱导；干细胞分化；组织工程

Key words: Cardiomyopathy, Dilated, Stem Cells, Cell Transplantation, Meta-Analysis, Tissue Engineering

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