Konstanty-Kalandyk Janusz, Sadowski Jerzy, Kędziora Anna, Urbańczyk-Zawadzka Małgorzata, Baran Jakub, Banyś Paweł, Kapelak Bogusław, Piątek Jacek
Department of Cardiovascular Surgery and Transplantology, John Paul II Hospital, Krakow, Poland.
Jagiellonian University Medical College, Krakow, Poland.
Stem Cells Int. 2021 Apr 22;2021:5556800. doi: 10.1155/2021/5556800. eCollection 2021.
A major clinical concern is the continuous increase in the number of patients diagnosed with advanced coronary artery disease, ischemic heart failure, and refractory angina, and one of the most promising treatment options for these conditions is stem cell-based therapy. The aim of this study was to assess the functional improvement following intramyocardial injection of adipose-derived stromal cells, using cardiac magnetic resonance.
Thirteen patients with ischemic heart failure, reduced left ventricular ejection fraction, refractory angina, and who have been disqualified from any form of direct revascularization were enrolled in the study with transthoracic autologous adipose-derived stromal cell implantation. All patients underwent cardiac magnetic resonance prior to the procedure and after 12 months of follow-up. A significant increase in stroke volume (83.1 ± 8.5 mL vs 93.8 ± 13.8 mL, = 0.025) and stroke volume index (43.3 ± 7.6 mL/m vs 48.7 ± 9.1 mL/m, = 0.019), a statistical trend toward an increase in left ventricle ejection fraction (36.7 ± 13.2 vs 39.7 ± 14.9, = 0.052), and cardiac output improvement (5.0 ± 0.7 vs 5.5 ± 0.9, = 0.073) was observed in the patient postprocedure. Enhanced relative regional thickening was noted in the segments with adipose-derived stromal cell implantation.
Intramyocardial adipose-derived stromal cell implantation is a promising therapeutic option for selected, symptomatic patients with ischemic heart failure, who have preserved myocardial viability despite being unsuitable for direct revascularization.
临床上一个主要的关注点是，被诊断患有晚期冠状动脉疾病、缺血性心力衰竭和顽固性心绞痛的患者数量持续增加，而针对这些病症最有前景的治疗选择之一是基于干细胞的疗法。本研究的目的是使用心脏磁共振评估心肌内注射脂肪源性基质细胞后的功能改善情况。
13例患有缺血性心力衰竭、左心室射血分数降低、顽固性心绞痛且不符合任何形式直接血运重建条件的患者参与了经胸自体脂肪源性基质细胞植入研究。所有患者在手术前和随访12个月后均接受了心脏磁共振检查。术后患者的每搏输出量显著增加（83.1±8.5毫升对93.8±13.8毫升，P=0.025）和每搏输出量指数显著增加（43.3±7.6毫升/米对48.7±9.1毫升/米，P=0.019），左心室射血分数有增加的统计趋势（36.7±13.2对39.7±14.9，P=0.052），心输出量也有所改善（5.0±0.7对5.5±0.9，P=0.073）。在植入脂肪源性基质细胞的节段中观察到相对局部增厚增强。
对于选定的有症状的缺血性心力衰竭患者，尽管不适合直接血运重建但心肌仍具有活力，心肌内脂肪源性基质细胞植入是一种有前景的治疗选择。
