Tayyareci Yelda, Umman Berrin, Sezer Murat, Beşişik Sevgi, Sanli Yasemin, Mudun Ayşe, Gürses Nuray, Nişanci Yilmaz
Florence Nightingale Hastanesi Kardiyoloji Bölümü, Istanbul Universitesi Istanbul Tip Fakültesi, Istanbul, Turkey.
Turk Kardiyol Dern Ars. 2008 Dec;36(8):519-29.
It has been demonstrated that intracoronary stem cell transplantation may have beneficial effects on left ventricular function and perfusion both in patients with acute and chronic ischemic cardiomyopathy (ICMP). We evaluated the safety and feasibility of intracoronary autologous bone marrow-derived mononuclear stem cell (MSC) implantation in patients with ICMP.
The study included 15 patients (14 males, 1 female; mean age 49+/-11 years) with ICMP. All the patients received MSC transplantation via a balloon catheter to the target vessel which had been revascularized by percutaneous coronary intervention and was patent before the procedure. Evaluations were made at baseline and 6, 12, and 18 months after the procedure with complete clinical and laboratory examinations, and by treadmill exercise test, conventional echocardiography, and SPECT imaging.
At six months, left ventricular ejection fraction increased significantly (p=0.001), hypoperfused areas on SPECT images reduced (p=0.002), and both myocardial oxygen consumption (p=0.001) and metabolic equivalents (p=0.001) increased. These beneficial effects of stem cell therapy were also observed at 12 and 18 months. No complications or in-hospital events occurred related with the procedure.
Due to its beneficial effects on heart failure symptoms, left ventricular function, and perfusion, intracoronary stem cell transplantation can be used as an alternative, adjunctive treatment option in patients with ICMP.
已证实冠状动脉内干细胞移植对急性和慢性缺血性心肌病(ICMP)患者的左心室功能和灌注可能具有有益作用。我们评估了冠状动脉内自体骨髓来源的单个核干细胞(MSC)植入ICMP患者的安全性和可行性。
该研究纳入了15例ICMP患者(14例男性,1例女性;平均年龄49±11岁)。所有患者均通过球囊导管将MSC移植至经皮冠状动脉介入已实现血管重建且术前通畅的靶血管。在基线时以及术后6、12和18个月进行评估,包括完整的临床和实验室检查、平板运动试验、传统超声心动图和SPECT成像。
六个月时,左心室射血分数显著增加(p = 0.001),SPECT图像上的灌注不足区域减少(p = 0.002),心肌耗氧量(p = 0.001)和代谢当量(p = 0.001)均增加。在12个月和18个月时也观察到了干细胞治疗的这些有益效果。未发生与该操作相关的并发症或住院期间事件。
由于冠状动脉内干细胞移植对心力衰竭症状、左心室功能和灌注具有有益作用,可作为ICMP患者的一种替代、辅助治疗选择。