[Early results of bone marrow cell transplantation to the myocardium of patients with heart failure due to Chagas disease].
OBJECTIVE
To evaluate early effects of bone marrow cell transplantation to the myocardium of patients with heart failure (CHF) due to Chagas disease.


METHODS
We studied 28 patients (mean age 52.2 +/- 9.9), of whom 24 were male. Despite optimized treatment, 25 patients were in NYHA class III and three patients, in NYHA class IV. The procedure consisted of aspiration of 50 mL of bone marrow, separation of the mononuclear fraction, and intracoronary injection. Effects on left ventricle ejection fraction (LVEF), distance walked in the six-minute walking test, quality-of-life, NYHA class, arrhythmogenic and biochemical parameters, were all evaluated.


RESULTS
There were no complications directly related to the procedure. Baseline left ventricular ejection fraction was 20.1 +/- 6.8%, and 60 days after transplantation it increased to 23.0 +/- 9.0%, p = 0.02. Significant improvements were observed in the NYHA class (3.1 +/- 0.3 to 1.8 +/- 0.5; p < 0.0001); quality-of-life (50.9 +/- 11.7 to 21.8 +/- 13.4; p < 0.0001); and distance walked in six minutes (355 +/- 136 m to 443 +/- 110 m; p = 0,003). The number of ventricular premature beats in 24 hours tended to increase (5,322 +/- 4,977 to 7,441 +/- 7,955; p = 0,062), but without increase in ventricular tachycardia episodes (61 +/- 127 to 54 +/- 127; p = 0.27).


CONCLUSIONS
Our data demonstrate for the first time that intracoronary injection of bone marrow mononuclear cells is feasible and suggest that it may be potentially safe and effective in patients with CHF due to Chagas disease.
Vilas-Boas
Fábio
F
Hospital Santa Izabel, Centro de Pesquisas Gonçalo Moniz, Salvador, BA. fabiovboas@cardiol.br
Feitosa
Gilson S
GS
Soares
Milena B P
MB
Mota
Augusto
A
Pinho-Filho
Joel Alves
JA
Almeida
Augusto José Gonçalves
AJ
Andrade
Marcus Vinicius
MV
Carvalho
Heitor G
HG
Dourado-Oliveira
Adriano
A
Ribeiro-dos-Santos
Ricardo
R
D000328:Adult; D000368:Aged; D016026:Bone Marrow Transplantation / Q000592:standards*; D002303:Cardiac Output, Low / Q000209:etiology / Q000601:surgery*; D002598:Chagas Cardiomyopathy / Q000150:complications / Q000601:surgery*; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012964:Sodium / Q000032:analysis; D033581:Stem Cell Transplantation / Q000592:standards; D013234:Stem Cells / Q000166:cytology; D016896:Treatment Outcome
D012964:Sodium