MedPath

Retrograde Application of Bone Marrow Aspirate Concentrate

Phase 2
Completed
Conditions
Heart Failure
Interventions
Drug: BMAC
Registration Number
NCT03372954
Lead Sponsor
University Hospital Ostrava
Brief Summary

The aim of our prospective randomised study is to assess the efficacy of the retrograde application of non-selected bone marrow autologous cells concentrate (BMAC) in patients with heart failure with reduced ejection fraction of left ventricle (HFREF) of ischemic aetiology. The evaluated preparation is concentrated BMAC, obtained using Harvest SmartPReP2 technology.

Detailed Description

Our assumption is that non-selected BMAC administrations will lead to improvements in the left ventricular ejection fraction (LV EF), the left ventricular end-systolic and end-diastolic diameters and volumes (measured with magnetic resonance imaging) compared to standard heart failure therapy.

Furthermore, it will be associated with improved exercise tolerance in the six-minute corridor walk test and an improvement in the life quality of patients without increasing the incidence of severe ventricular arrythmias.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
40
Inclusion Criteria
  • Patients with chronic heart failure and left ventricular ejection fraction ≤ 40% with coronary artery disease and with symptoms of heart failure in the NYHA class ≥ 3 on standard heart failure therapy for 3 months and in a stabilised state for at least 1 month
  • Age ≥18 years
  • Informed, written consent by the patient
  • Ability to comply fully with the study protocol
  • Negative pregnancy test (and effective contraception) in women with childbearing potential
Exclusion Criteria
  • Previous bone marrow disease (especially myelodysplastic syndrome or non-Hodgkin's lymphoma)
  • Acute myocardial infarction ˂ 1 week
  • Active infection or antibiotics treatment ˂ 1 week
  • Previous malingant ventricular arrhythmias without cardioverter-defibrilator (ICD) implantation
  • Anemia (HTC≤28%), leukocythosis (≥ 14.000/mm3) or thrombocytopenia (≤50.000/mm3)
  • Previous bleeding diathesis
  • Need for hematopoietic growth factor treatment (e.g. erythropoetin, G-CSF)
  • Impossibility of aspiration 240ml of bone marrow
  • Hepathopathy or cirrhosis (bilirubin, ALT or AST ≥ 2,5x upper limit of normal)
  • Terminal renal insufficiency or haemodyalysis
  • Uncontrolled hypertension
  • Need for high dose (> 7.5mg/day) corticotherapy within the next 6 months
  • Inability to stop anticoagulation therapy (>72 hours) before bone marrow aspiration
  • Known malignancies requiring actino or chemotherapy, or previous actinotherapy
  • Patients with a BMI >40
  • Known allergy to contrast agents
  • Other comorbidities with a life expectancy of 6 months

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Bone marrow autologous cells concentrate (BMAC)BMACretrograde administration on non-selected BMAC via coronary sinus
ControlBMACstandard treatment o heart failure
Primary Outcome Measures
NameTimeMethod
Left ventricular end-systolic diameter (LVESd)12 month

Left ventricular end-systolic diameter

Left ventricular end-systolic volume (LVESV)12 month

Left ventricular end-systolic volume

Left ventricular end-diastolic diameter (LVEDd)12 month

Left ventricular end-diastolic diameter

ejection fraction of left ventricle (EF LV)12 month

ejection fraction of left ventricle

Left ventricular end-diastolic volume (LVEDV)12 month

Left ventricular end-diastolic volume

Secondary Outcome Measures
NameTimeMethod
corridor walk test12 month

walk distance in 6 min corridor walk test

QoL12 month

Quality of patients´ life using the Minnesota questionnaire

Trial Locations

Locations (1)

University Hospital Ostrava

🇨🇿

Ostrava-Poruba, Moravian-Silesian Region, Czechia

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