Options for using cellular cardiomyoplasty for coronary heart disease

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Abstract

Background. Despite a significant arsenal of medications and methods of surgical correction of myocardial blood supply, treatment of some forms of coronary heart disease remains relevant. Aim of the work is to analyze the effectiveness of the use of mesenchymal stem cells (МSC) of bone marrow in autologous transendocardial transplantation in some forms of IHD.

Methods. In the near and long-term results, we analyzed the histories and diseases and conducted a survey of 68 patients. Of the 68 patients, the largest group was men — 53 (77.9%), women were much fewer — 15 (22.1%). Then we formed 4 groups (17 patients each): 1 group — control — patients received standard drug therapy; Group 2 — to patients who received standard therapy, empty myocardial injections were performed using a catheter and the NOGA XP navigation system; Group 3 — auto-CCK was administered intravenously to patients; 4 group — against the background of therapy, transendocardial auto-МSС was administered.

Results. When analyzing the patient’s subjective sensations in group I, after 3 months in group 1, 4 patients (32%) noted improvement, unchanged — 11 (64.7%), worsening — 2 (11.8%) and significant worsening 1 (5.9%). In group 2, improvement was in 1 patient, which was 5.9%, unchanged — 13 (76.5%), worsening — 2 (11.8%) and significant deterioration — 2 (11.8%). In group 3, improvement was observed in 5 patients — 29.4%, significant improvement in 1 (5.9%), deterioration and significant deterioration in 1 patient (5.9% each, respectively). In group 4 unchanged — 6 (35.3%) patients, improvement — 7 (41.2%), significant improvement — 4 (32%), worsening — 1 (5.9%). Cell transplantation, regardless of the method of administration, increases the EF and reduces the EDV of the left ventricle, more significantly in the group with a transendocardial route of administration.

Conclusion. In accordance with published data, we obtained similar data — transplantation of human bone marrow SSC with autologous administration causes a positive effect in the form of increased EF LV, decreased EDV of the LV, increased exercise tolerance and a significant improvement in patients’ well-being. It should be noted that intravenous and intracoronary administration of auto-МSC is less effective in the studied parameters than transendocardial introduction of cells into the myocardium.

About the authors

Vyacheslav Yu. Mykhaylichenko

Medical Academy named after S. I. Georgievsky of V. I. Vernadsky Crimean Federal University

Author for correspondence.
Email: pancreas1978@mail.ru
ORCID iD: 0000-0003-4204-5912

MD, PhD, Professor

Russian Federation, 5/7 Lenin’s boulevard, Simferopol 295051, Republic of Crimea

Yuri D. Kostyamin

Donetsk State Medical University named after Gorky

Email: kostiamin@mail.ru

MD, PhD

Donetsk, DNR

Sergey A. Samarin

Medical Academy named after S. I. Georgievsky of V. I. Vernadsky Crimean Federal University

Email: samarinmd@gmail.com
ORCID iD: 0000-0002-7046-624X
SPIN-code: 6971-3905

MD, PhD

Russian Federation, 5/7, Lenina blvrd., Simferopol, Respublic of Crimea, 295051

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2. Figure: 1. Electromechanical record of patient H., 68 years old, with a diagnosis of ischemic heart disease, angina pectoris FC 4, postinfarction (Q-MI of the lower wall of the left ventricle in 2001, without Q-MI of the anterior wall of the left ventricle in 2005) and atherosclerotic cardiosclerosis; AKSH-2 and MKSH-1 in 2006. Shunt occlusion to the blunt edge branch. Stenting of the circumflex branch of the left coronary artery in 2012

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Copyright (c) 2020 Mykhaylichenko V.Y., Kostyamin Y.D., Samarin S.A.

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