自体骨髓来源细胞心肌内植入治疗缺血性心脏病的短期和长期疗效

Short- and long-term outcomes of intramyocardial implantation of autologous bone marrow-derived cells for the treatment of ischaemic heart disease.

作者信息

Kurazumi Hiroshi, Fujita Akira, Nakamura Tamami, Suzuki Ryo, Takahashi Masaya, Shirasawa Bungo, Mikamo Akihito, Hamano Kimikazu

机构信息

Department Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Japan.

Department of Clinical Pharmacology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.

出版信息

Interact Cardiovasc Thorac Surg. 2017 Mar 1;24(3):329-334. doi: 10.1093/icvts/ivw412.

DOI:10.1093/icvts/ivw412

PMID:28040755

Abstract

OBJECTIVES

Ischaemic heart disease remains a major cause of death in Japan. We have implanted autologous bone marrow-derived cells locally into the ischaemic region as a therapy in addition to coronary artery bypass grafting since 1999. We describe the outcomes of our cell therapy for ischaemic heart disease.

METHODS

Eleven patients underwent local implantation of bone marrow-derived cells into the ischaemic region during coronary artery bypass grafting. Clinical outcomes during the acute and chronic phases were recorded.

RESULTS

In the acute phase, no adverse effects were observed. Left ventricular ejection fraction values were not significantly different before and after treatment. Seven of the 11 patients showed improved blood perfusion in the area of cell therapy 1 month after treatment. In the chronic phase, 5 of 11 patients exhibited improved regional blood flow 1 year after treatment. Overall survival at 1, 5 and 10 years was 100%, 83.3% and 83.3%, respectively. Freedom from major adverse cardiac and cerebrovascular events at 1, 5 and 10 years was 100%, 80.8% and 80.8%, respectively. Death from all causes or freedom from major adverse cardiac and cerebrovascular events at 1, 5 and 10 years was 100%, 64.6% and 64.6%, respectively.

CONCLUSIONS

Local implantation of bone marrow-derived cells in patients with ischaemic heart disease is safe and feasible. Cell therapy is a therapeutic option for otherwise untreatable ischaemic heart disease.

摘要

目的

在日本，缺血性心脏病仍然是主要的死亡原因。自1999年以来，除冠状动脉搭桥术外，我们还将自体骨髓来源的细胞局部植入缺血区域作为一种治疗方法。我们描述了我们对缺血性心脏病进行细胞治疗的结果。

方法

11例患者在冠状动脉搭桥术期间将骨髓来源的细胞局部植入缺血区域。记录急性期和慢性期的临床结果。

结果

在急性期，未观察到不良反应。治疗前后左心室射血分数值无显著差异。11例患者中有7例在治疗后1个月时细胞治疗区域的血流灌注得到改善。在慢性期，11例患者中有5例在治疗后1年时局部血流得到改善。1年、5年和10年的总生存率分别为100%、83.3%和83.3%。1年、5年和10年无重大不良心脑血管事件的发生率分别为100%、80.8%和80.8%。1年、5年和10年全因死亡或无重大不良心脑血管事件的发生率分别为100%、64.6%和64.6%。