Abstract
The idiopathic dilated cardiomyopathy (IDC) is one of the major public health problems in the western world. Patients with IDC in functional class IV (New York Health Association - NYHA), even after therapeutic optimization, have high mortality. Stem cell therapy has emerged as a potential therapeutic option for cell death-related heart diseases and several positive effects were assigned to cell therapy in cardiomyopathy. The aim of this study was identify short-term result of cell transplantation in idiopathic dilated cardiomyopathy patients (IDC) who were treated by transplantation of autologous bone marrow mononuclear cells (BMMC). Intracoronary injections of autologous BMMC were performed in eight patients with severe ventricle dysfunction (mean of left ventricle ejection fraction – LEVF=20.03%), cardiac mass muscle around 156.2 g and NYHA between III and IV grades, other 8 IDC patients received placebo. The IDCs were followed - up for one and two years, by magnetic resonance imaging (MRI). The results after one year showed significant improvement in LVEF (mean=181.4) and muscle mass increasing (mean=181.4 g), after two years the LVEF continued improving, reaching a mean of 32.69% and the cardiac muscle mass kept stable (mean=179.4 g). Excepted for one patient, all the other had improvement in the NYHA functional class. The placebo group did not show any improvement. We believe that BMMC implant may be a beneficial therapeutic option for IDC patients.
Highlights
Cardiovascular disease is one of the major public health problems in the western world
The left ventricle ejection fraction (LVEF) descriptive statistics can be observed in Table 1 and these results were calculated based on measurements made both before cell therapy (T0), after one year of therapy (T1) and after two years (T2)
The analysis of extreme values shown that there was a positive evolution on left volume ejection fraction (LVEF), which is most significant in the first year
Summary
Cardiovascular disease is one of the major public health problems in the western world. In Brazil, it is estimated that 2% of the population are affected by dilated cardiomyopathy [3] and the cardiovascular mortality rate, in 2004, was 286 people per 100,000 inhabitants [2,3,4,5,6,7,8]. Dilated cardiomyopathy is a disease without effective therapeutic options in addition to cardiac transplantation [8,9,10,11,12,13,14]. Organ rates are low and most of the patients on transplant waiting list died before receiving a new heart [15,16,17,18,19,20]. A therapy capable of improving cardiac function and more accessible to the population is of great interest [21]
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