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Published on: March 1, 2016
Bone-marrow mononuclear cell therapy of severe ischemic heart failure
Hans Fernando R Dohmann1, Suzana A Silva, André L S Souza
1Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, and Hospital Pró-Cardíaco - PROCEP, Rio de Janeiro, Brazil.
Insights
Autologous bone-marrow-derived mononuclear cell therapy significantly improved heart function and reduced symptoms in severe ischemic heart failure patients. This cell therapy shows promise for
Area of Science:
- Regenerative Medicine
- Cardiovascular Biology
- Cell Therapy
Background:
- Severe ischemic heart failure presents a significant clinical challenge with limited therapeutic options.
- Autologous bone-marrow-derived mononuclear cells offer a potential regenerative approach.
Purpose of the Study:
- To evaluate the efficacy and safety of transendocardial injection of autologous bone-marrow-derived mononuclear cells for severe ischemic heart failure.
- To assess the impact of cell therapy on cardiac function, patient symptoms, and myocardial structure.
Main Methods:
- Transendocardial injection of autologous bone-marrow-derived mononuclear cells into the myocardium.
- Assessment of clinical outcomes, including heart failure symptoms and angina.
- Evaluation of cardiac function using electrical and mechanical mapping.
- Anatomopathological examination of myocardial tissue post-treatment.
Main Results:
- Significant reduction in heart failure symptoms and angina.
- Sustained improvement in cardiac pumping power, exercise capacity, and myocardial irrigation.
- Evidence of sustained neoangiogenesis and improved cardiomyocyte activity and quantity in treated regions.
- Absence of adverse effects reported in treated patients.
Conclusions:
- Autologous bone-marrow-derived mononuclear cell therapy is a safe and effective treatment for severe ischemic heart failure.
- The therapy promotes myocardial regeneration and functional recovery in 'no-option' cardiac patients.
- Further research into cell selection may optimize therapeutic outcomes.
Abstract:
We describe cell therapy for severe ischemic heart failure using transendocardial injection of autologous bone-marrow-derived mononuclear cells. The treated patients had significantly less heart failure and angina, sustained significant improvement of pumping power, exercise capacity, cardiac muscle irrigation, and blood supply to the body. Electrical and mechanical mappings of the myocardium before and after the therapy, and anatomopathological examination of the myocardium of one of the patients that had deceased of a stroke eleven months after the treatment indicated sustained neoangiogenesis and improvement of activity and quantity of cardiomyocytes in the injected regions. Post-hoc analyses of injected cell phenotype and improvement of myocardial function indicate that presence of CD8+ and CD56+ cells does not correlate with good prognostics, suggesting a possibility of cell selection. For 'no-option' severe cardiac patients, significant benefits of cell therapy and absence of adverse effects may justify the application of bone-marrow-derived cell therapy.
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