Intracoronary infusion of CD133+ endothelial progenitor cells improves heart function and quality of life in patients with chronic post-infarct heart insufficiency

Autor: Daniel Cervantes-García, Artemio Uribe-Longoria, María M. Rangel-Fuentes, Luciana P. Espinosa-Oliveros, Genoveva J. Benavides-Chereti, Juan L. González-Treviño, Rosario Salazar-Riojas, Ramiro Flores-Ramírez, Augusto Rojas-Martinez, Ramón H. Limón-Rodríguez, José H. Treviño-Ortiz, Rogelio Monreal-Puente, Pedro Gutiérrez-Fajardo
Rok vydání: 2010
Předmět:
Male
Time Factors
medicine.medical_treatment
Myocardial Infarction
Cell Separation
Coronary Angiography
Ventricular Function
Left
Natriuretic Peptide
Brain
AC133 Antigen
Heart transplantation
Ejection fraction
Hematopoietic Stem Cell Transplantation
General Medicine
Stroke volume
Middle Aged
Magnetic Resonance Imaging
Treatment Outcome
Echocardiography
cardiovascular system
Cardiology
Female
Cardiology and Cardiovascular Medicine
Adult
medicine.medical_specialty
Sudden death
Antigens
CD
Internal medicine
Angioplasty
medicine
Humans
Infusions
Intra-Arterial
Aged
Glycoproteins
Heart Failure
Tomography
Emission-Computed
Single-Photon
business.industry
Endothelial Cells
Stroke Volume
Recovery of Function
medicine.disease
Myocardial Contraction
Death
Sudden
Cardiac
Heart failure
Chronic Disease
Quality of Life
Myocardial infarction complications
Myocardial infarction diagnosis
Peptides
business
Biomarkers
Zdroj: Cardiovascular Revascularization Medicine. 11:72-78
ISSN: 1553-8389
DOI: 10.1016/j.carrev.2009.04.001
Popis: Aim To assess the safety and efficacy of the intracoronary infusion of CD133+ hematopoietic stem cells to improve ventricular function and quality of life in candidates for heart transplantation due to post-infarct chronic heart failure. Methods We selected seven candidates for heart transplantation (six males/one female, age range 44–65 years) in whom all treatment alternatives were exhausted (angioplasty/stent and bypass surgery). These subjects had a symptomatic New York Heart Association (NYHA) scale of at least II and ejection fractions (EFs) below 35%. After obtaining informed consent, CD133+ cells were obtained by stimulation with granulocyte-colony stimulating factor, apheresis, and separation with magnetic beads. Stem cells were implanted in the infarcted zone via intracoronary percutaneous angiography. Evaluations (NYHA scale classification, plasma concentration of pro-B-natriuretic-peptide and the risk of sudden death, echocardiography, cardiac magnetic resonance, and gated-SPECT with MIBI) were performed at baseline and at 3, 6, 12, and 24 months after cell infusion. Results Stem cell isolation was efficient and safe (around 10 7 cells/patient and >92% CD133+ viable cells). Two patients died during observation due to noncardiac conditions. In the five remaining subjects, the NYHA scale improved and no accounts of hospital admissions for heart failure were documented. Plasma concentrations of pro-B-natriuretic peptide and the risk of sudden death clearly decreased, while the EF increased significantly to 35% and 40% by echocardiography and cardiac MRI, respectively ( P =.013 and .009, respectively) 24 months after treatment. No other major adverse events were noticed. Conclusions The intracoronary inoculation of CD133+ stem cells was safe and effective to improve ventricular contraction and symptomatic class function in patients with refractory post-infarct heart failure.
Databáze: OpenAIRE
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