scholarly journals The Features of Systolic Function and Remodelation of the Left Ventricle in Patients with Rheumatoid Arthritis in Combination with Arterial Hypertension

2020 ◽  
Vol 5 (5) ◽  
pp. 118-124
Author(s):  
I. O. Daniuk ◽  
◽  
N. G. Ryndina ◽  
Y. V. Ivashchuk ◽  
◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Essential Hypertension ◽  
Left Ventricle ◽  
Systolic Function ◽  
Control Group ◽  
Myocardial Mass ◽  
Systolic Volume ◽  
End Diastolic Volume ◽  
End Systolic Volume ◽  
Left Atrium Size

Recent studies have shown that heart disease in patients with rheumatoid arthritis occurs according to various data in 20-100% of cases. Hypertension is often the first objectively detectable marker of cardiovascular pathology in patients with rheumatoid arthritis. Hypertension in patients with rheumatoid arthritis usually becomes an active initiator and accelerator of the progression of atherosclerosis and remodeling of the left ventricle. Cardiac remodeling in patients with hypertension and in patients with rheumatoid arthritis, combined with hypertension is a significant factor that affects to the quality of life and prognosis and requires careful study of this problem. The purpose of the work was to study the systolic function and morphological parameters of the left ventricle in patients with rheumatoid arthritis in combination with hypertension and to establish indicators associated with high cardiovascular risk. Material and methods. The main group of patients consisted of 93 patients with rheumatoid arthritis of moderate activity in combination with hypertension stage II. The second group included 45 patients with essential hypertension stage II. The control group had 31 almost healthy people. An ultrasound examination of the heart was performed with studying of systolic function and the main morphological parameters of the left ventricle. Results and discussion. We found a significant increase in the left ventricle myocardial mass index by 11.97% in patients with rheumatoid arthritis in combination with hypertension compared to the patients with essential hypertension and by 30.1% compared to the control group. We also detected the significant increase of the interventricular septum thickness by 9.02%, the posterior wall of left ventricle – by 5.51%, and the relative wall thickness of left ventricle – by 6.0% in patients with rheumatoid arthritis in combination with hypertension compared to the patient with essential hypertension. There was a significant increase in end-diastolic volume by 8.64%; end-systolic volume – by 12.95%; and a decrease of ejection fraction by 2.5% in patients with rheumatoid arthritis in combination with hypertension with m SCORE >4 points compared to the corresponding indicators of patients with m SCORE ≤4 points. The study showed that the most common type of left ventricle remodeling was concentric left ventricle hypertrophy (79% of patients) in patients with rheumatoid arthritis with hypertension. In addition, the subgroup of patients with m SCORE >4 points left ventricle myocardial mass and left ventricle myocardial mass index were by 15.01% and 14.86% significantly higher than the corresponding indicators in the subgroup of patients with m SCORE ≤4 points. Conclusion. The patients with rheumatoid arthritis in combination with hypertension showed an association between increasing of the left atrium size and the volume parameters of the left ventricle, and the presence of fluid in the pericardial cavity. This was manifested by the left atrium size increase by 10.65%, end-diastolic volume – by 8.62%, end-systolic volume – by 12.2% and the ejection fraction decrease by 2.23% in patients with fluid versus to a subgroup of patients without fluid in the pericardium

Biplane ventriculography in the rat

1986 ◽  
Vol 250 (1) ◽  
pp. H131-H136
Author(s):  
J. L. Heckman ◽  
L. Garvin ◽  
T. Brown ◽  
W. Stevenson-Smith ◽  
W. P. Santamore ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Stroke Volume ◽  
Methyl Methacrylate ◽  
High Speed ◽  
Water Displacement ◽  
Systolic Volume ◽  
End Diastolic Volume ◽  
End Systolic Volume

Biplane ventriculography was performed on nine intact anesthetized rats. Images of the left ventricle large enough for analysis were obtained by placing the rats close to the radiographic tubes (direct enlargement). Sampling rates, adequate for heart rates of 500 beats/min, were obtained by filming at 500 frames/s. From the digitized silhouettes of the left ventricle the following information was obtained (means +/- SE): end-diastolic volume 0.60 +/- 0.03 ml, end-systolic volume 0.22 +/- 0.02 ml, stroke volume 0.38 +/- 0.02 ml, ejection fraction 0.63 +/- 0.02, cardiac output 118 +/- 7 ml/min, diastolic septolateral dimension 0.41 +/- 0.01 mm, diastolic anteroposterior dimension 0.40 +/- 0.01 mm, diastolic base-to-apex dimension 1.58 +/- 0.04 mm. To determine the accuracy with which the volume of the ventricle could be measured, 11 methyl methacrylate casts of the left ventricle were made. The correlation was high (r = 0.99 +/- 0.02 ml E) between the cast volumes determined by water displacement and by use of two monoplane methods (Simpson's rule of integration and the area-length method applied to the analysis of the anteroposterior films) and a biplane method (area-length). These results demonstrate that it is possible to obtain accurate dimensions and volumes of the rat left ventricle by use of high-speed ventriculography.

Serum tumor necrosis factor-alpha does not mediate endotoxin-induced myocardial depression in rabbits

1996 ◽  
Vol 270 (2) ◽  
pp. H485-H491 ◽  
Author(s):  
Y. Nishikawa ◽  
J. Mathison ◽  
W. Y. Lew
Keyword(s):  
Tumor Necrosis ◽  
Tnf Alpha ◽  
Control Group ◽  
Lv Function ◽  
Necrosis Factor Alpha ◽  
Systolic Volume ◽  
End Diastolic Volume ◽  
End Systolic Volume ◽  
Factor Alpha ◽  
Necrosis Factor

Tumor necrosis factor-alpha (TNF-alpha) is an endogenous mediator for several effects of endotoxin. To evaluate whether TNF-alpha mediates endotoxin-induced left ventricular (LV) dysfunction, we measured LV function (sonomicrometers) and serum TNF-alpha (cytolytic assay) in anesthetized rabbits given endotoxin (100 micrograms/kg iv). In the control group (n = 8), systolic depression (defined by a > 10% increase in end-systolic volume at a matched end-systolic pressure) developed in four rabbits and diastolic dilation (> 10% increase in end-diastolic volume at a matched end-diastolic pressure) developed in three rabbits. Neither the increase in end-systolic volume nor the increase in end-diastolic volume correlated with the increase in TNF-alpha, which reached a peak of 2,875 +/- 762 U/ml. In a second group of rabbits (n = 7), a goat polyclonal anti-rabbit antibody to TNF-alpha was given 30-60 min before endotoxin. Anti-TNF-alpha antibody alone did not alter LV function. Although the TNF-alpha response to endotoxin was effectively blunted (peak TNF-alpha remained < 100 U/ml), all seven rabbits developed systolic depression (P = 0.08 compared with control group) and diastolic dilation (P = 0.03). We conclude that serum TNF-alpha does not mediate endotoxin-induced LV systolic depression or diastolic dilation in this model.

scholarly journals 1180 2D and 3D assessment of the left ventricle volume and ejection fraction in a general population

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
F Ericsson ◽  
B Tayal ◽  
K Hay Kragholm ◽  
T Zaremba ◽  
N Holmark Andersen ◽  
...  
Keyword(s):  
General Population ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Large Population ◽  
Systolic Volume ◽  
End Diastolic Volume ◽  
Significant Difference ◽  
End Systolic Volume ◽  
The Mean ◽  
2D And 3D

Abstract Introduction In standard practice, LV volumes and EF are estimated by 2D technique. 3D echocardiographic assessment seems more reliable; however, this method has not yet been validated in the general population. Purpose To validate 3D echocardiography in a large population sample and investigate differences between 2D and 3D LVEF and volumes Methods In The Copenhagen City Heart Study, 4466 echocardiograms were available for analysis. The echocardiograms were obtained during four consecutive heartbeats in both 2D and 3D with GE Vivid E9. Offline analysis was performed on EchoPac v. 201. LVEF was calculated by the modified Simpsons Biplane Auto EF for 2D and by the 4LVQ method for 3D. Results The study included 2090 echocardiograms. The mean 2D LVEF was 57.3 ± 6.1% (IQR 54 - 61%) and 51.7 ± 7.9% (IQR 47 - 57%) by 3D. The mean end-diastolic volume (EDV) and end-systolic volume (ESV) by 2D and 3D techniques were: EDV 2D 106.1 ± 29.6 ml vs EDV 3D 128.2 ± 32.3 ml , ESV 2D 45.7 ± 15.6 ml vs. ESV 3D 45.7 ± 20.7 , p &lt; 0.05 among all variables. The average difference of means between 2D and 3D LVEF was 5.6 ± 11.2%, -22.1 ± 56.8 ml for EDV, and -16.9 ± 32.9 ml for ESV. The correlation coefficient for LVEF was 0.42, EDV 0.76 and for ESV 0.70. Conclusion In our study, we found a significant difference in both LVEF and ventricular volumes when comparing 2D echocardiograms with 3D. 3DE had, in general, lower LVEF, higher EDV and ESV compared to 2D. Table 1: Summary of results Table 1 - Summary of results n = 2090 Variable Min Max Mean IQR (25-75) p-value LVEF, 2D (%) 18 76 57.3 ± 6.1 54-61 &lt; 0.05 LVEF, 3d (%) 13 77 51.7 ± 7.9 47-57 &lt; 0.05 EDV, 2D (ml) 13 275 106.1 ± 29.6 85-123.8 &lt; 0.05 EDV, 3D (ml) 50 270 128.2 ± 32.3 106-148 &lt; 0.05 ESV, 2D (ml) 15 150 45.7 ± 15.6 35-54 &lt; 0.05 ESV, 3D (ml) 13 185 45.7 ± 20.7 48-74 &lt; 0.05 LVEF: left ventricle ejection fraction, EDV: end-diastolic volume, ESV: end systolic volume, IQR: Inter-quartile range Abstract 1180 Figure 1: Correlation and BA-plot

Dimensional analysis of the left ventricle: effects of acute aortic regurgitation

1975 ◽  
Vol 228 (2) ◽  
pp. 536-542 ◽  
Author(s):  
SJ Leshin ◽  
LD Horwitz ◽  
JH Mitchell
Keyword(s):  
Left Ventricle ◽  
Aortic Regurgitation ◽  
Diastolic Pressure ◽  
Systolic Pressure ◽  
Left Ventricular ◽  
Systolic Volume ◽  
Severe Aortic Regurgitation ◽  
End Diastolic Volume ◽  
Catheter Technique ◽  
End Systolic Volume

The effects of acute severe aortic regurgitation on the left ventricle were investigated in conscious, chronically instrumented dogs. Left ventricular dimensions and volumes were measured from biplane cineradiographs of beads positioned near the endocardium. Data were collected before and after the production of aortic regurgitation by a catheter technique. The aortic regurgitation resulted in increases in mean aortic pulse pressure from 44 to 73 mmHg (P smaller than 0.001), heart rate from 87 to 122 beats/min (P smaller than 0.02), and left ventricular end-diastolic pressure from 11 to 25 mmHg (P smaller than 0.05). Mean end-diastolic volume rose from 61 to 69 cc (P smaller than 0.001), while end-systolic volume remained unchanged at 37 cc. The end-diastolic dilatation following regurgitation was asymmetrical in that the increase in size was due principally to an increase in the septal-lateral axis. The acute volume load of aortic regurgitation was accomplished by an increase in end-diastolic volume, i.e., the Frank-Starling mechanism. The tachycardia probably reflects augmented cardiac sympathetic activity, but the constant end-systolic volume at a similar mean systolic pressure suggests that the net contractile state was unchanged.

P3808iBox-CRT: Better response, less complicated, equally fast

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
I Aguiar Ricardo ◽  
A Nunes-Ferreira ◽  
J Rigueira ◽  
J Agostinho ◽  
R Santos ◽  
...  
Keyword(s):  
Left Ventricle ◽  
Response Rate ◽  
Control Group ◽  
Conduction Delay ◽  
Study Group ◽  
Automatic Assessment ◽  
Systolic Volume ◽  
End Diastolic Volume ◽  
The Mean

Abstract Introduction The optimization of the left ventricle (LV) pacing site guided by the electrical delay increases CRT response rate (RR), however it's necessary to develop technology that allows its universal use. Purpose The aim is automatically, and operator-independent, access the conduction delay between the right ventricular (RV) stimulus and the LV available veins in order to select the LV pacing site. It is further intended to compare the total procedure and radiation times in relation to an historical control group. Methods Prospective, single-center study that included patients undergoing CRT implant according to the current ESC Guidelines. All patients were submitted to a clinical, electrocardiographic and echocardiographic basal evaluation prior to CRT implantation and at 6 months of follow-up. To evaluate conduction delays between the RV lead and the LV available veins (RV-LV delay), an external interface - intelligent Box for CRT (iBox-CRT) was used. Four measurements in at least two different tributary veins were made. The implant of all the LV leads was guided by the longest measured delay. A positive response to CRT was defined as an improvement of >10% in left ventricle ejection fraction (LVEF) or a reduction of end-systolic volume (ESV)>15%. The results were compared to a control group (CG) of pts submitted to CRT implantation in the conventional way. Results 60 patients were included (68.3% males, 38% ischemic, mean age 67.4±10.2 years) and submitted to CRT implant (37 CRT-P; 23 CRT-D). At basal evaluation, LVEF was 28±7%, end-diastolic volume (EDV) was 200±73ml and ESV 145±64ml. CG (n=51) had similar characteristics. The RR was 85.7%, significantly higher compared to the CG (55.9%, p=0.003). The ESV reduced 38.2±3% in responders vs 5.7±2% in non-responders (NR) (p=0,005), EDV reduced 33.3±16% in responders vs 13.6±10% in NR (p=0.002), the mean LVEF improved 11% in responders vs −1% in NR (p=0.02). At follow-up, the mean ESV in the study group (SG) was 89±44 ml vs 132±75ml in the CG (p=0.002) and the EDV 136±51 vs 190±78 (p=0.007). In addition to a much better response rate, the responders in the study group had significantly higher mean LVEF at follow-up (39±11% vs 37±7%, p=0.032). The mean intra-procedure RV-LV delay was 187±34mseg. In the responder group the baseline delay was usually higher (190±35 msec) vs NR group RV-LV delay (165±23 msec; p=NS). Compared with CG, the automatic assessment of RV-LV delay with iBox-CRT did not increase fluoroscopy time (15±16min vs 18±16; p=NS) and shortened procedure time (65±34 vs 108±83min, p<0.005). Conclusions The iBox-CRT use enabled an automatic and operator independent RV-LV delays measurement, in order to implant the LV lead at the most delayed site. This technique translated into a major increase in CTR response rate, not compromising the procedure duration nor increasing the radiation exposure.

scholarly journals SYSTOLIC FUNCTION AND DYSSYNCHRONY IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

2013 ◽  
Vol 4 (2) ◽  
pp. 4-11
Author(s):  
N A Yaroschuk ◽  
V V Kochmasheva ◽  
V P Dityatev ◽  
O B Kerbikov
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Pulmonary Hypertension ◽  
Normal Values ◽  
Systolic Function ◽  
Systolic Pressure ◽  
Control Group ◽  
Systolic Volume ◽  
End Diastolic Volume ◽  
Group Standard Deviation

Echographic evaluation of systolic function plays an important role in examination of the patients with acute myocardial infarction (AMI). Recent developments in real-time 3D echocardiography (RT3DE) allow us to evaluate additional parameters such as the dyssynchrony.The aim of this study was to evaluate the relationship between myocardium dyssynchrony and systolic function and to assess the prognostic value of dyssynchrony and its influence on the development of arrhythmias and fatal event in post AMI period.Methods: Study population consisted of 82 (mean age 52±21) patients with AMI and 65 age and gender matched persons with similar cardiovascular risk factors, but without AMI (control group). Standard deviation of the time to the regional LV minimum systolic volume for all 16 segments Tmsv4 16-SD index was used for the assessment of dyssynchrony. The follow-up period was 6 months afterAMI.Results: Tmsv 16-SD values were significantly higher in patients with MI compared control group (6.8 ± 2.7% vs 2.9 ± 1.6 % respectively, р<0,001). Moderate negative correlation was observed between Tmsv 16-SD and Cardiac Index (CI) (r =-0.58, p<0.008). No significant correlations were found between Tmsv 16-SD and mean arterial pressure and herat rate. Tmsv 16-SD was significantly lower in patients with pulmonary hypertension (maximum systolic pressure in lung artery (SPLA) – 55.0±5.58 mm Hg) as compared to patients without pulmonary hypertension (maximum SPLA – 33.0±5.76 mmHg); 4.9±0.75 vs 6.1±1.88 respectively, р=0.03. Significant positive correlation was observed between Tmsv 16-SD and end-diastolic volume (EDV) (r=0.63; р<0.05) and negative with ejection fraction (EF) (r=-0.73; p<0.05).28 patients (34%) of the MI group had the increase Tmsv 16-SD and normal values of EDV and EF. According to ROC analysis ROC Tmsv 16-SD>6.1 was associated with arrhythmic complications in post IM period (sensitivity 83.3%, specificity 87.5%, AUC=0.865, p<0.0001). Tmsv 16SD>6.1 correlates with increasing likelihood of fatal event (sensitivity 87.5%, specificity 71.6%, AUC=0.81, p<0.0001)Conclusions: Tmsv 16-SD is increased in patients with MI. In 34% of MI patients the increase of Tmsv 16-SD was observed in combination normal values of EF and EDV which allow us to consider Tmsv 16-SD as an additional indicator describing pathological changes in myocardium. Tmsv16-SD is correlated with hemodynamic indicators such as CI and SPLA. High Tmsv 16-SD is associated with increased level of arrhythmic complications and fatal events.

scholarly journals Elevated end systolic function in a rat model of temporal lobe epilepsy

2018 ◽  
Author(s):  
Tiina Pirttimäki ◽  
Hanne Laakso ◽  
Alejandra Sierra ◽  
Caitlin Cunningham ◽  
Timo Liimatainen ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Rat Model ◽  
Systolic Function ◽  
Premature Death ◽  
Unexpected Death ◽  
Systolic Volume ◽  
End Diastolic Volume ◽  
End Systolic Volume ◽  
Heart Size

Sudden unexpected death in epilepsy (SUDEP) is a common cause of premature death amongst epilepsy patients. It is hypothesized to result from cardiorespiratory dysfunction, but the exact aetiology is unknown. The aim of this study was to determine if functional cardiovascular alterations were present in rats with chronic epileptic behaviour. Naive control rats were compared to a rat model of temporal lobe epilepsy that was induced using a repeated low-dose kainic acid (KA) protocol. The results indicate that end-systolic volume was significantly (p=0.01) higher in the epileptic group whilst end-diastolic volume did not reach significance (p=0.08). Ejection fraction, stroke volume, cardiac output, heart rate, body weight and heart size were also measured and appeared similar between groups. These initial data support the use cardiac magnetic resonance imaging (cMRI) to investigate cardiovascular changes across disease development of epilepsy-like behaviour, which may offer insight into understanding SUDEP.

Endotoxin-induced left ventricular depression is blocked by nitrogen mustard or dimethylthiourea in rabbits

1995 ◽  
Vol 269 (3) ◽  
pp. H1098-H1105
Author(s):  
Y. Nishikawa ◽  
W. Y. Lew
Keyword(s):  
Nitrogen Mustard ◽  
Diastolic Pressure ◽  
Systolic Pressure ◽  
Left Ventricular ◽  
Free Radical Scavenger ◽  
Control Group ◽  
Radical Scavenger ◽  
Systolic Volume ◽  
End Diastolic Volume ◽  
End Systolic Volume

We examined endotoxin-induced myocardial depression in 31 anesthetized rabbits using left ventricular end-systolic and end-diastolic pressure-volume relationships (sonomicrometers). In the control group, endotoxin (100 micrograms/kg iv) induced systolic depression (> 10% increase in end-systolic volume at matched end-systolic pressure) in 9 of 16 and diastolic dilation (> 10% increase in end-diastolic volume at matched end-diastolic pressure) in 8 of 16 rabbits within 7 h, unrelated to hypotension, acidosis, or hypoxia. Seven rabbits were pretreated with nitrogen mustard (1-2 mg/kg iv 4 and 2 days before) to decrease circulating neutrophils and monocytes by 98%. Endotoxin did not induce systolic depression in any rabbit (P = 0.01 compared with control), and diastolic dilation developed in one rabbit (P = 0.12). In eight rabbits pretreated with dimethylthiourea (DMTU; 500 mg/kg iv 30 min before), an intracellular free radical scavenger, systolic depression developed in one (P = 0.05) and diastolic dilation in five (P = 0.44). We conclude that cells inhibited by nitrogen mustard (e.g., neutrophils, monocytes, or macrophages) mediate endotoxin-induced left ventricular systolic depression. DMTU inhibited endotoxin-induced systolic but not diastolic dysfunction.

scholarly journals Elevated end systolic function in a rat model of temporal lobe epilepsy

2018 ◽  
Author(s):  
Tiina Pirttimäki ◽  
Hanne Laakso ◽  
Alejandra Sierra ◽  
Caitlin Cunningham ◽  
Timo Liimatainen ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Rat Model ◽  
Systolic Function ◽  
Premature Death ◽  
Unexpected Death ◽  
Systolic Volume ◽  
End Diastolic Volume ◽  
End Systolic Volume ◽  
Heart Size

Sudden unexpected death in epilepsy (SUDEP) is a common cause of premature death amongst epilepsy patients. It is hypothesized to result from cardiorespiratory dysfunction, but the exact aetiology is unknown. The aim of this study was to determine if functional cardiovascular alterations were present in rats with chronic epileptic behaviour. Naive control rats were compared to a rat model of temporal lobe epilepsy that was induced using a repeated low-dose kainic acid (KA) protocol. The results indicate that end-systolic volume was significantly (p=0.01) higher in the epileptic group whilst end-diastolic volume did not reach significance (p=0.08). Ejection fraction, stroke volume, cardiac output, heart rate, body weight and heart size were also measured and appeared similar between groups. These initial data support the use cardiac magnetic resonance imaging (cMRI) to investigate cardiovascular changes across disease development of epilepsy-like behaviour, which may offer insight into understanding SUDEP.

A Systematic Review and Meta-analysis : Safety and Efficacy of Mesenchymal stem Cells Therapy for Heart Failure

2020 ◽  
Vol 15 ◽  
Author(s):  
Tiantian Shen ◽  
Lin Xia ◽  
Wenliang Dong ◽  
Jiaxue Wang ◽  
Feng Su ◽  
...  
Keyword(s):  
Heart Failure ◽  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Safety And Efficacy ◽  
Systolic Volume ◽  
End Diastolic Volume ◽  
End Systolic Volume

Background: Preclinical and clinical evidence suggests that mesenchymal stem cells (MSCs) may be beneficial in treating heart failure (HF). However, the effects of stem cell therapy in patients with heart failure is an ongoing debate and the safety and efficacy of MSCs therapy is not well-known. We conducted a systematic review of clinical trials that evaluated the safety and efficacy of MSCs for HF. This study aimed to assess the safety and efficacy of MSCs therapy compared to the placebo in heart failure patients. Methods: We searched PubMed, Embase, Cochrane library systematically, with no language restrictions. Randomized controlled trials(RCTs) assessing the influence of MSCs treatment function controlled with placebo in heart failure were included in this analysis. We included RCTs with data on safety and efficacy in patients with heart failure after mesenchymal stem cell transplantation. Two investigators independently searched the articles, extracted data, and assessed the quality of the included studies. Pooled data was performed using the fixed-effect model or random-effect model when it appropriate by use of Review Manager 5.3. The Cochrane risk of bias tool was used to assess bias of included studies. The primary outcome was safety assessed by death and rehospitalization and the secondary outcome was efficacy which was assessed by six-minute walk distance and left ventricular ejection fraction (LVEF)，left ventricular end-systolic volume（LVESV），left ventricular end-diastolic volume（LVEDV） and brain natriuretic peptide（BNP） Results: A total of twelve studies were included, involving 823 patients who underwent MSCs or placebo treatment. The overall rate of death showed a trend of reduction of 27% (RR [CI]=0.73 [0.49, 1.09], p=0.12) in the MSCs treatment group. The incidence of rehospitalization was reduced by 47% (RR [CI]=0.53[0.38, 0.75], p=0.0004). The patients in the MSCs treatment group realised an average of 117.01m (MD [95% CI]=117.01m [94.87, 139.14], p<0.00001) improvement in 6MWT.MSCs transplantation significantly improved left ventricular ejection fraction (LVEF) by 5.66 % (MD [95% CI]=5.66 [4.39, 6.92], p<0.00001), decreased left ventricular end-systolic volume (LVESV) by 14.75 ml (MD [95% CI]=-14.75 [-16.18, -12.83], p<0.00001 ) and left ventricular end-diastolic volume (LVEDV) by 5.78 ml (MD [95% CI]=-5.78[-12.00, 0.43], p=0.07 ) ,in the MSCs group , BNP was decreased by 133.51 pg/ml MD [95% CI]= -133.51 [-228.17,-38.85], p=0.54, I2= 0.0%) than did in the placebo group. Conclusions: Our results suggested that mesenchymal stem cells as a regenerative therapeutic approach for heart failure is safe and effective by virtue of their self-renewal potential, vast differentiation capacity and immune modulating properties. Allogenic MSCs have superior therapeutic effects and intracoronary injection is the optimum delivery approach. In the tissue origin, patients who received treatment with umbilical cord MSCs seem more effective than bone marrow MSCs. As to dosage injected, (1-10)*10^8 cells were of better effect.

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