Westphal RJ, Bueno RRL, Galvão PBDA, Zanis Neto J, Souza JM, Guérios ÊE, Senegaglia AC, Brofman PR, Pasquini R, Cunha CLPD. Autologous transplantation of bone marrow adult stem cells for the treatment of idiopathic dilated cardiomyopathy.
Arq Bras Cardiol 2015;
103:521-9. [PMID:
25590932 PMCID:
PMC4290743 DOI:
10.5935/abc.20140164]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2014] [Accepted: 08/05/2014] [Indexed: 11/30/2022] Open
Abstract
Background
Morbimortality in patients with dilated idiopathic cardiomyopathy is high, even
under optimal medical treatment. Autologous infusion of bone marrow adult stem
cells has shown promising preliminary results in these patients.
Objective
Determine the effectiveness of autologous transplantation of bone marrow adult
stem cells on systolic and diastolic left ventricular function, and on the degree
of mitral regurgitation in patients with dilated idiopathic cardiomyopathy in
functional classes NYHA II and III.
Methods
We administered 4,54 x 108 ± 0,89 x 108 bone marrow
adult stem cells into the coronary arteries of 24 patients with dilated idiopathic
cardiomyopathy in functional classes NYHA II and III. Changes in functional class,
systolic and diastolic left ventricular function and degree of mitral
regurgitation were assessed after 3 months, 6 months and 1 year.
Results
During follow-up, six patients (25%) improved functional class and eight (33.3%)
kept stable. Left ventricular ejection fraction improved 8.9%, 9.7% e 13.6%, after
3, 6 and 12 months (p = 0.024; 0.017 and 0.018), respectively. There were no
significant changes neither in diastolic left ventricular function nor in mitral
regurgitation degree. A combined cardiac resynchronization and implantable
cardioversion defibrillation was implanted in two patients (8.3%). Four patients
(16.6%) had sudden death and four patients died due to terminal cardiac failure.
Average survival of these eight patients was 2.6 years.
Conclusion
Intracoronary infusion of bone marrow adult stem cells was associated with an
improvement or stabilization of functional class and an improvement in left
ventricular ejection fraction, suggesting the efficacy of this intervention. There
were no significant changes neither in left ventricular diastolic function nor in
the degree of mitral regurgitation.
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