Objective: Left ventricular assist devices (LVADs) are utilized as a bridge to transplant or as destination therapy for patients with end-stage heart failure. Although cardiac offloading from these devices rarely leads to complete remodeling and functional recovery, the use of mesenchymal cells to modulate heart failure has been explored in recent years due to its intrinsic regenerative properties. Current methods of evaluating cardiac function have too much variability, difficulty of access, or require too frequent follow up to create universal weaning protocols. We hypothesized that the administration of amniotic allograft liquid matrix (LM) containing amnion-derived mesenchymal stem cells (aMSCs) in patients with LVADs could improve left ventricular function and be positively associated with pulsatility.
Methods: Flow cytometry, mass spectroscopy, and enzyme-linked immunoassays were used to characterize aMSCs and LM that were administered to 9 patients with LVADs. Results were compared to samples from 7 control patients with LVADs that did not receive aMSC and LM.
Results: Patients who received aMSCs and LM (n=9) demonstrated a significant increase in standardized pulsatility at 30 (P = .007), 90 (P = .02), and 180 (P = .05) days post-implant when compared to control patients who did not receive the treatment (n=7).
Discussion: We conclude that the use of aMSCs and LM in patients with LVADs could be a promising treatment strategy, and pulsatility can be a reproducible and consistent diagnostic metric to evaluate left ventricular function without intra- or inter-observer variability.
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Mikail, Philemon; Skaria, Rinku; Slepian, Marvin; Garcia, Janny; Smith, Richard; and Khalpey, Zain
"Pulsatility is a Predictive Marker of Improved Cardiac Function in Patients with Liquid Matrix-treated Left Ventricular Assist Devices,"
The VAD Journal: Vol. 8(1)
Available at: https://digitalcommons.library.tmc.edu/vad/vol8/iss1/5