OPTIONS FOR USING CELLULAR CARDIOMYOPLASTY FOR CORONARY HEART DISEASE

Abstract

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. The purpose of the work is to analyze the effectiveness of the use of stromal stem cells (SSC) of bone marrow in autologous transendocardial transplantation in some forms of IHD. Material and 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-SSK was administered. Results and its discussion. 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 II, 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 III, 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 IV 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-SSC is much less effective in the studied parameters than transendocardial introduction of cells into the myocardium.