BACKGROUND: Demonstration that the heart is not a post-mitotic organ has led to clinical trials trying to obtain myocardial repair even in patients with heart failure. AIM OF THE STUDY: To evaluate as a less invasive method for promoting cardiac repair. METHODS: Thirteen patients with ischemic heart failure in NYHA and/or CCS classes >/=3 unsuitable for revascularization received G-CSF, as a compassionate use, in addition to optimal medical therapy. Symptoms and cardiac perfusion by gated-SPECT were assessed at baseline and at 4month follow up. RESULTS: G-CSF was generally well tolerated. NYHA and CCS classes improved significantly from 3 (IR 2.5-3) to 2 (IR 1-2.5) (p=0.012) and from 3 (IR 1-3) to 1 (IR 1-2) (p=0.033). Heart failure severity symptoms according to the Minnesota Living with Heart Failure Questionnaire scores exhibited a non significant improvement from 52+/-27 to 39+/-26 (p=0.15). At the Seattle Angina Questionnaire scores (ranging from 0 to 100, higher scores indicating better status), physical limitation improved from 39+/-31 to 64+/-29 (p=0.03), angina stability from 42+/-29 to 64+/-28 (p=0.05), angina frequency from 53+/-33 to 73+/-26 (p=0.04), treatment satisfaction from 67+/-29 to 83+/-21 (p=0.07), disease perception from 37+/-29 to 66+/-26 (p=0.007). Quality of life assessed by a Visual Analogue Scale improved from 33+/-24 to 64+/-20mm (p=0.003). Stress and differential regional perfusion scores improved significantly from 1.78+/-1.38 to 1.66+/-1.38 (p=0.05) and from 0.35+/-0.68 to 0.23+/-0.53 (p=0.02) respectively. CONCLUSIONS: In patients with ischemic heart failure unsuitable for revascularization, G-CSF is associated to a significant improvement of symptoms, possibly reducing stress-induced ischemia.

Leone, A. M., Giannico, M. B., Bruno, I., Giordano, A., Zaccone, V., Perfetti, M., Niccoli, G., Porto, I., Burzotta, F., Rebuzzi, A. G., Biasucci, L. M., Crea, F., Safety and efficacy of G-CSF in patients with ischemic heart failure: The CORNER (Cell Option for Recovery in the Non-Eligible patients for Revascularization) study., <<INTERNATIONAL JOURNAL OF CARDIOLOGY>>, 2011; 2011 (Luglio): 75-78. [doi:10.1016/j.ijcard.2010.02.075] [http://hdl.handle.net/10807/33283]

Safety and efficacy of G-CSF in patients with ischemic heart failure: The CORNER (Cell Option for Recovery in the Non-Eligible patients for Revascularization) study.

Leone, Antonio Maria;Giannico, Maria Benedetta;Bruno, Isabella;Giordano, Alessandro;Zaccone, Vincenzo;Niccoli, Giampaolo;Porto, Italo;Burzotta, Francesco;Rebuzzi, Antonio Giuseppe;Biasucci, Luigi Marzio;Crea, Filippo
2011

Abstract

BACKGROUND: Demonstration that the heart is not a post-mitotic organ has led to clinical trials trying to obtain myocardial repair even in patients with heart failure. AIM OF THE STUDY: To evaluate as a less invasive method for promoting cardiac repair. METHODS: Thirteen patients with ischemic heart failure in NYHA and/or CCS classes >/=3 unsuitable for revascularization received G-CSF, as a compassionate use, in addition to optimal medical therapy. Symptoms and cardiac perfusion by gated-SPECT were assessed at baseline and at 4month follow up. RESULTS: G-CSF was generally well tolerated. NYHA and CCS classes improved significantly from 3 (IR 2.5-3) to 2 (IR 1-2.5) (p=0.012) and from 3 (IR 1-3) to 1 (IR 1-2) (p=0.033). Heart failure severity symptoms according to the Minnesota Living with Heart Failure Questionnaire scores exhibited a non significant improvement from 52+/-27 to 39+/-26 (p=0.15). At the Seattle Angina Questionnaire scores (ranging from 0 to 100, higher scores indicating better status), physical limitation improved from 39+/-31 to 64+/-29 (p=0.03), angina stability from 42+/-29 to 64+/-28 (p=0.05), angina frequency from 53+/-33 to 73+/-26 (p=0.04), treatment satisfaction from 67+/-29 to 83+/-21 (p=0.07), disease perception from 37+/-29 to 66+/-26 (p=0.007). Quality of life assessed by a Visual Analogue Scale improved from 33+/-24 to 64+/-20mm (p=0.003). Stress and differential regional perfusion scores improved significantly from 1.78+/-1.38 to 1.66+/-1.38 (p=0.05) and from 0.35+/-0.68 to 0.23+/-0.53 (p=0.02) respectively. CONCLUSIONS: In patients with ischemic heart failure unsuitable for revascularization, G-CSF is associated to a significant improvement of symptoms, possibly reducing stress-induced ischemia.
2011
Inglese
Leone, A. M., Giannico, M. B., Bruno, I., Giordano, A., Zaccone, V., Perfetti, M., Niccoli, G., Porto, I., Burzotta, F., Rebuzzi, A. G., Biasucci, L. M., Crea, F., Safety and efficacy of G-CSF in patients with ischemic heart failure: The CORNER (Cell Option for Recovery in the Non-Eligible patients for Revascularization) study., <<INTERNATIONAL JOURNAL OF CARDIOLOGY>>, 2011; 2011 (Luglio): 75-78. [doi:10.1016/j.ijcard.2010.02.075] [http://hdl.handle.net/10807/33283]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10807/33283
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