title: Autologous transplantation of bone marrow adult stem cells for the treatment of idiopathic dilated cardiomyopathy.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil.
authors.forename: Ricardo João
authors.initials: RJ
authors.lastname: Westphal
authors.affiliation: Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil.
authors.forename: Ronaldo Rocha Loures
authors.initials: RR
authors.lastname: Bueno
authors.affiliation: Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil.
authors.forename: Paulo Bezerra de Araújo
authors.initials: PB
authors.lastname: Galvão
authors.affiliation: Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil.
authors.forename: José
authors.initials: J
authors.lastname: Zanis Neto
authors.affiliation: Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil.
authors.forename: Juliano Mendes
authors.initials: JM
authors.lastname: Souza
authors.affiliation: Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil.
authors.forename: Ênio Eduardo
authors.initials: ÊE
authors.lastname: Guérios
authors.affiliation: Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil.
authors.forename: Alexandra Cristina
authors.initials: AC
authors.lastname: Senegaglia
authors.affiliation: Centro de Pesquisa, Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brazil.
authors.forename: Paulo Roberto
authors.initials: PR
authors.lastname: Brofman
authors.affiliation: Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Pasquini
authors.affiliation: Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil.
authors.forename: Claudio Leinig Pereira da
authors.initials: CL
authors.lastname: Cunha
mesh_terms: D000328:Adult; D053687:Adult Stem Cells / Q000637:transplantation*; D000368:Aged; D016026:Bone Marrow Transplantation / Q000379:methods* / Q000401:mortality; D002311:Cardiomyopathy, Dilated / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D003331:Coronary Vessels / Q000601:surgery; D003971:Diastole / Q000502:physiology; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000503:physiopathology; D015203:Reproducibility of Results; D018709:Statistics, Nonparametric; D013599:Systole / Q000502:physiology; D013997:Time Factors; D014182:Transplantation, Autologous / Q000379:methods / Q000401:mortality; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000502:physiology