The results of intramyocardial implantation of autologous bone marrow cells treated with erythropoietin in the surgical treatment of coronary artery disease with severe lesion of vessels

Aim. To assess safety and efficacy of intramyocardial implantation of autologous bone marrow cells treated with erythropoietin in surgery for coronary artery disease (CAD).Materials and methods. Eighty patients with CAD with diffuse and (or) distal lesions of the right coronary artery were randomly assigned to two groups: patients of group 1 (n=40) underwent coronary bypass surgery, implantation of autologous bone marrow cells treated with erythropoietin into the lower wall of the left ventricle, patients of group 2 (control group, n=40) underwent bypass surgery of the left coronary artery. Evaluation of the clinical status, perfusion and contractility of the myocardium was performed initially, 6 and 12 months after surgery.Results. Six months after the operation, we found more pronounced decrease of functional class (FC) of angina and improvement in the 6-min walk distance in the main group compared with the control group.Twelve months after surgery, the severity of angina remained at the same level in both groups. In the control group, 45,2% of patients had FC I, 52,3% of patients did not have angina. In both groups, angina return was detected in 1 patient (FC III). According to the results of two-step myocardial scintigraphy with Technetril (Tc99), 6 months after surgery, a significant improvement in myocardial perfusion was observed. In the control group, after 6 months, no significant dynamics of perfusion of the lower wall of the left ventricle was detected.Twelve months after the surgical treatment of the right coronary artery in patients from the group 1 revealed a decrease in the stress defect and the stable perfusion defect. In patients from the control only a significant stress defect was found to decrease.Conclusion. The study demonstrated decrease of FCs, significant improvement in perfusion, functional state of the myocardium and 6-min walk distance in patients of group 1.

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Clinical and functional evaluation of intramyocardial implantation of autologous bone marrow cells treated with erythropoietinduring the CAD surgery (6-month results)

Russian Journal of Transplantology and Artificial Organs ◽

10.15825/1995-1191-2018-4-89-99 ◽

2019 ◽

Vol 20 (4) ◽

pp. 89-99

Author(s):

A. V. Fomichev ◽

A. M. Chernyavskiy ◽

K. K. Gulyaeva ◽

O. V. Poveschenko ◽

A. P. Lykov ◽

...

Keyword(s):

Bone Marrow ◽

Perfusion Defect ◽

Bone Marrow Cells ◽

Coronary Bypass ◽

Autologous Bone Marrow ◽

Control Group ◽

Bypass Grafting ◽

Coronary Bypass Grafting ◽

Autologous Bone ◽

Marrow Cells

Aim.Clinical and functional evaluation of the implantation of autologous bone marrow cells treated with erythropoietin in laser channels during coronary bypass grafting in patients with end-stage coronary lesion.Materials and methods.60 patients with coronary artery disease with diffuse and (or) distal right coronary artery disease were randomized into two groups: patients of group 1 (n = 30) underwent coronary bypass grafting, implantation of autologous bone marrow cells treated with erythropoietin in laser channels, patients of the 2nd group (n = 30) were operated with coronary bypass grafting of the left coronary artery system. Assessment of the clinical status, myocardial perfusion and contractility was performed initially, 6 months after the operation.Results.Six months after the operation, there was a more pronounced decrease in angina pectoris (CCS) in the main group compared to the control group, also we revealed a 6-minute walk test scores improvement. Based on two-stage scintigraphy (Tc99) in the main group before the surgical treatment, a rest perfusion defect was 8.5% [3.5, 18.5], a stress-induced perfusion defect – 7.0% [6.0, 12, 3]. In the control group, the rest defect was 9.1% [5.6, 12.4], the stress-induced perfusion defect was 7.3% [6.1, 8.7]. 6 months after surgery rest perfusion defect at the indirect revascularization group was 6.0% [2.5, 16.5] (p = 0.008), a stress-induced defect was 4.0% [1.5, 6.3] (p = 0.05). In the control group, the rest defect was 8.7% [5.3, 10.3], the stress-induced perfusion defect was 6.8% [5.3, 9.1] (p = 0.21). The results of scintigraphy with MIBG showed a left ventricle innervation defect (PID) significant decrease in the main group: initially 15.4% [14.2, 16.3], after 6 months 11.7% [9.3, 13, 2] (p = 0.045). In the control group, there was an unreliable decrease in PID: initially 14.3% [10.2, 17.3], after 6 months 13.8% [9.1, 14.2] (p = 0.14).Conclusion.Our preliminary results revealed more pronounced effect of the new indirect revascularization method expressed as in myocardial perfusion improve, myocardial sympathetic innervation restoration and clinical status improvement in comparison with control group.

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1025-64 Long-term clinical outcome of catheter-based intramyocardial autologous bone marrow cells implantation in patients with end-stage coronary artery diseases

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(04)90162-3 ◽

2004 ◽

Vol 43 (5) ◽

pp. A39 ◽

Cited By ~ 1

Author(s):

Hung-Fat Tse ◽

Sukumaran Thambar ◽

Yok-Lam Kwong ◽

John K.F Chan ◽

Gladys Lo ◽

...

Keyword(s):

Bone Marrow ◽

Coronary Artery ◽

Clinical Outcome ◽

Bone Marrow Cells ◽

Autologous Bone Marrow ◽

Coronary Artery Diseases ◽

Autologous Bone ◽

End Stage ◽

Marrow Cells

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Abstract 2390: Düsseldorfer-ABCD Trial (Autologous Bone Marrow Cells in Dilated Cardiomyopathy)

Circulation ◽

10.1161/circ.118.suppl_18.s_716 ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Christiana M Schannwell ◽

Muhammad Yousef ◽

Carmen M Basalyk ◽

Tobias Zeus ◽

Michael Brehm ◽

...

Keyword(s):

Bone Marrow ◽

Clinical Trials ◽

Side Effects ◽

Bone Marrow Cells ◽

Autologous Bone Marrow ◽

Left Ventricular ◽

Control Group ◽

Group I ◽

Autologous Bone ◽

Marrow Cells

Heart failure is a dangerous disease with an increasing frequency. Although conventional drug therapy may delay remodeling, there is no basic therapeutic regime available for preventing or even reversing this process. Several preclinical as well as clinical trials have shown that transplantation of autologous bone marrow cells improved cardiac function after myocardial infarction and chronic heart disease (CAD). We investigated the effects of intracoronary (ic) autologous stem cell transplantation (STX) at patients with non-ischemic dilated cardiomyopathy (DCM). Methods: A total of 10 patients with DCM were included in this study (group I). The control group also consists of 10 age and sex-matched patients with comparable ejection fraction (group II). CAD and myocarditis were excluded. All patients of group I received an ic autologous STX with mononuclear cells. Cell transplantation was performed via the ic administration route. All cells were infused directly into the dominant coronary vessel. To achieve a maximal ischemic stimulus all patients received Dobutamine intravenously and Dipipyridamol by ic application. All 20 patients were re-investigated after 3 months. Results: Three months after ic STX, the global left ventricular ejection fraction increased in patients from 18 ± 1 up to 26 ± 3% (p < 0.01). In parallel the physical ability (functional capacity) rose from 25 to 75 watt (p < 0.01). In addition, we found an improvement of maximum oxygen uptake under stress from 1236 ± 217 up to 1473 ± 198 ml/min (p < 0.01). Furthermore we documented a reduction of arrythmia. An unchanged or even impaired left ventricular function was not observed in any patient of group I. In the control group (group II) no significant changes were documented. No side effects of ic autologous STX were found, particularly no arrythmias, no heart insufficiency, no dyspnoea and no palpitations. Conclusion: These results show that transplantation of autologous bone marrow cells, as well as the ic approach, represents a novel and effective therapeutic procedure for the therapy of DCM. For this method of therapy, no ethical problems exist, and no side effects were observed. However, further experimental studies and controlled prospective clinical trials have to follow.

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