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Autologous transplantation of bone marrow adult stem cells for the treatment of idiopathic dilated cardiomyopathy.

Westphal RJ, Bueno RR, Galvão PB, Zanis Neto J, Souza JM, Guérios ÊE, Senegaglia AC, Brofman PR, Pasquini R, Cunha CL - Arq. Bras. Cardiol. (2014)

Bottom Line: During follow-up, six patients (25%) improved functional class and eight (33.3%) kept stable.There were no significant changes neither in diastolic left ventricular function nor in mitral regurgitation degree.There were no significant changes neither in left ventricular diastolic function nor in the degree of mitral regurgitation.

View Article: PubMed Central - PubMed

Affiliation: Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil.

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 10(8) ± 0,89 x 10(8) 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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Method of calculating the myocardial performance index (IPM), or Tei index.ECG: electrocardiogram; TCI: isovolumetric contraction time; TRI: isovolumetricrelaxation time; TE: ejection time.
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f04: Method of calculating the myocardial performance index (IPM), or Tei index.ECG: electrocardiogram; TCI: isovolumetric contraction time; TRI: isovolumetricrelaxation time; TE: ejection time.

Mentions: Representing systolic and diastolic functions, the myocardial performance index, orTei index, was defined as the ratio between the total isovolumetric times(contraction and relaxation) and left ventricular ejection time (NV = 0.34-0.44).This was calculated by subtracting the time between the beginning and the end of thesystolic aortic flow from the time elapsed between the closing and the opening of themitral valve, and dividing this result by LV ejection time (figure 4)20.


Autologous transplantation of bone marrow adult stem cells for the treatment of idiopathic dilated cardiomyopathy.

Westphal RJ, Bueno RR, Galvão PB, Zanis Neto J, Souza JM, Guérios ÊE, Senegaglia AC, Brofman PR, Pasquini R, Cunha CL - Arq. Bras. Cardiol. (2014)

Method of calculating the myocardial performance index (IPM), or Tei index.ECG: electrocardiogram; TCI: isovolumetric contraction time; TRI: isovolumetricrelaxation time; TE: ejection time.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4290743&req=5

f04: Method of calculating the myocardial performance index (IPM), or Tei index.ECG: electrocardiogram; TCI: isovolumetric contraction time; TRI: isovolumetricrelaxation time; TE: ejection time.
Mentions: Representing systolic and diastolic functions, the myocardial performance index, orTei index, was defined as the ratio between the total isovolumetric times(contraction and relaxation) and left ventricular ejection time (NV = 0.34-0.44).This was calculated by subtracting the time between the beginning and the end of thesystolic aortic flow from the time elapsed between the closing and the opening of themitral valve, and dividing this result by LV ejection time (figure 4)20.

Bottom Line: During follow-up, six patients (25%) improved functional class and eight (33.3%) kept stable.There were no significant changes neither in diastolic left ventricular function nor in mitral regurgitation degree.There were no significant changes neither in left ventricular diastolic function nor in the degree of mitral regurgitation.

View Article: PubMed Central - PubMed

Affiliation: Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil.

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 10(8) ± 0,89 x 10(8) 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.

Show MeSH
Related in: MedlinePlus