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BENEFICIAL EFFECT OF COMBINED (INTRAMYOCARDIAL AND INTRACORONARY) BONE MARROW-DERIVED STEM CELLS THERAPY IN PATIENTS WITH ISCHAEMIC HEART DISEASE AND SEVERLY DEPRESSED LEFT VENTRICULAR FUNCTION

S. Charwat, M. Gyöngyösi, G. Beran, I. Lang, M. Dettke, H. Sochor, N. Nyolczas, D. Glogar (Wien, Austria)
Topic: a general field
Type: Presentation - doctors, 15th Alpe-Adria

Background: Implantation of bone marrow-derived stem cells (BM-SCs) into the failing heart may be a promising approach for cardiac regeneration in heart failure secondary to severe coronary artery disease.

Aim: The aim of the present study was to determine the effects of the combined (intramyocardial and intracoronary) percutaneous administration of non-selected BM-SCs therapy on the size of ischaemia, the clinical status and left ventricular function in no option patients with chronic myocardial ischaemia and severely depressed left ventricular function.
 Methods: Eighteen patients (94% men, mean age: 55.410.5 years) with previous myocardial infarction and left ventricular ejection fraction less than 35% under optimal medical treatment received combined NOGA-guided intramyocardial (4.00.6 ml) plus intracoronary (30.213.8 ml) autologous BM-SCs therapy (total cell number: 2.82x1093.39 x109; CD34+ cell number: 4.60x1074.41x107). Baseline and 6-month follow up 99m-Tc-MIBI-adenosin-perfusion scintigraphy for determination of size of resting and stress-induced perfusion defects, NOGA endocardial mapping for assessment of myocardial viability, contrast ventriculography for calculating of global left ventricular ejection fraction (EF), left ventricular end-systolic (ESV) and end-diastolic volume (EDV) were performed in all patients.
Results: A positive trend to smaller stress-induced perfusion defects (from 37.312.0% to 32.911.6%; p=0.07) and significant increase in mean unipolar voltage value of injected area measured by NOGA endocardial mapping (from 7.242.33 mV to 8.432.70 mV; p=0.007) (normal value > 14 mV) was observed after 6-month combined application form of BM-SCs therapy. Accordingly, the clinical status of patients improved (NYHA functional class from 2.690.96 to 1.740.95; p=0.001,