Bone marrow stem cell transplantation and coronary artery bypass grafting surgery for chronic ischemic myocardiopathy.
We studied 12 consecutive patients with chronic ischemic myocardiopathy treated with bone marrow adult stem cell (ASC) transplantation and coronary artery bypass grafting (CABG). The aim of the study was to evaluate functional class (New York Heart Association), wall motion score index (WMSI), and ejection fraction by echocardiography and to evaluate myocardial perfusion by single-photon emission computed tomography (SPECT). Follow-up evaluations were performed at 3, 6, and 12 months. The results revealed functional class improvement until 12 months, a progressive increase in the ejection fraction of 15% to 20% in the first 6 months, and a progressive increase in the WMSI by 35% to 45% in 12 months. Evaluation of the WMSI in the stem cell and CABG areas separately revealed a similar improvement in the first 3 months and a better progression in the CABG area. SPECT images revealed perfusion improvements in ischemic areas and no difference in fibrous tissue areas. These preliminary results show the safety of the method and its reproducibility. When performed concomitantly with CABG, bone marrow ASC transplantation may improve functional class, ejection fraction, WMSI, and myocardial perfusion. This study will be completed with all patients followed up for 12 months and compared with a control group.
Paraná Federal University Clinics Hospital, Curitiba, Brazil. dantonloures@onda.com.br
Danton Richlin
DR
da Rocha Loures
Juliano Mendes
JM
de Souza
Oaidia Adelina Nocetti
OA
Sermann
Noemi
N
Farah
Maria Felicitas Niedfeld
MF
Rodriguez
Mariester
M
Malvezzi
Tamara
T
Borgonovo
Ricardo João
RJ
Westphal
Lauro
L
Ervilha
Claudio Pereira
CP
da Cunha
D000704:Analysis of Variance; D018952:Antigens, CD34; D044963:Biopsy, Fine-Needle; D016026:Bone Marrow Transplantation / Q000009:adverse effects* / Q000706:statistics & numerical data; D016022:Case-Control Studies; D001026:Coronary Artery Bypass; D018450:Disease Progression; D006801:Humans; D008297:Male; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery*; D015425:Myocardial Reperfusion; D011446:Prospective Studies; D013318:Stroke Volume; D015899:Tomography, Emission-Computed, Single-Photon; D014463:Ultrasonography; D016277:Ventricular Function, Left
D018952:Antigens, CD34