Case report: Cytokine therapy and an intracoronary autologous bone marrow-derived cell infusion with Impella support in a patient with dilated cardiomyopathy and a severely reduced ejection fraction.

ABSTRACT

Introduction: This is the first reported case of a patient with dilated cardiomyopathy (DCM) and severely impaired left ventricular function to receive a combined treatment of granulocyte colony-stimulating factor therapy and an intracoronary delivery of autologous bone marrow-derived mononuclear cells with percutaneous circulatory assistance (the Impella CP device; Abiomed, Danvers, MA). Main symptoms and outcome: Three months post-treatment, the gentleman in his early 70s demonstrated an improvement in left ventricular ejection fraction (13-17%) and a reduction in New York Heart Association class from III to class I. There was also an improvement in his 6-minute walk test (147-357 meters), N-terminal pro-brain natriuretic peptide level (14,099-7,129 ng/l) and quality of life scores. There were no safety concerns during the treatment or follow-up. Conclusion: This case report suggests combined cell and cytokine therapy with adjunctive circulatory support could be a safe and promising treatment for patients with DCM and severely reduced ejection fraction.