[Sustained improvement in symptoms and exercise capacity up to six months after autologous transendocardial transplantation of bone marrow mononuclear cells in patients with severe ischemic heart disease].
OBJECTIVE
This study aimed at assessing the effects of autologous transendocardial transplantation of bone marrow mononuclear cells (ATTBMMC) on symptoms, exercise capacity, myocardial perfusion and contractility in patients with severe ischemic heart disease during a 6-month follow-up period.


METHODS
This prospective study comprised 21 patients as follows: the first 14 patients forming the treated group, and the last 7 patients forming the control group. Initially, all patients underwent clinical and laboratory assessment, treadmill testing, echocardiography, myocardial scintigraphy, and 24-hour Holter. The bone marrow mononuclear cells (BMMC) were isolated, washed, and diluted in 0.9% saline solution for transendocardial injection in areas of viable myocardium in the treated group, (15 0.2-mL injections). All patients were reassessed in the end of 2 and 6 months of follow-up.


RESULTS
The demographic data and other characteristics did not significantly differ between the groups in the initial evaluation. No major adverse events related to the ATTBMMC were observed. In the end of 6 months, a reduction in the ischemic area was observed on nuclear perfusion imaging (P=0.05), as was a significant improvement in symptoms, functional capacity, and left ventricular overall function.


CONCLUSIONS
This study showed that transendocardial injections of BMMC are safe in human beings with ischemic heart disease associated with severe ventricular dysfunction. The effects observed in the short run were maintained up to the sixth month of follow-up.
Dohmann
Hans Fernando R
HF
Hospital Pró-Cardíatico, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil. hdohmann@cardiol.br
Perin
Emerson C
EC
Borojevic
Radovan
R
Silva
Suzana A
SA
Souza
Andre L S
AL
Silva
Guilherme V
GV
Assad
João A R
JA
Rossi
Maria I D
MI
Mesquita
Claudio T
CT
Dohmann
Hans J
HJ
D016026:Bone Marrow Transplantation; D016021:Epidemiologic Studies; D005080:Exercise Test; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging / Q000601:surgery*; D018919:Neovascularization, Physiologic; D011877:Radionuclide Imaging; D014182:Transplantation, Autologous