Short-term and long-term results of intracoronary introduction of autologous mesenchymal stem cells in exertional angina pectoris
Notice bibliographique
Résumé
Purpose is to study the effectiveness of intracoronary introduction application of mesenchymal stem cells (MSC’s) in refractory angina pectoris.Material and methods. The study was based on the results founded by the investigation, treatment and dynamic follow-up results of 30 patients with refractory angina pectoris who underwent the stationary therapy in the department of Urgent and Recovery Cardiac surgery of SI «Institute of Urgent and Recovery Surgery named after V.K. Gusak of NAMS of Ukraine» from 2007 till 2014. We formed 2 groups; each of them included 15 patients: in the first group (a control one), the patients received only medicamental therapy; the second group received intracoronary administration of autologous MSC’s. According to NYHA (New York Heart Association) classification, all the patients had II-IV functional class of chronic heart failure (CHF). All the patients earlier went through the different revascularization surgeries. Mesenchymal autologous bone marrow stem cells were received according to the standard method in the laboratory of cellular and tissue cultivation of SI «Institute of Urgent and Recovery Surgery named after V.K. Gusak of NAMS of Ukraine». Using the local anesthesia with catheter application in the coronary vessel mouth was implemented a transplant in the dose of 10 million cells.Results. During the control examination, a clinical improvement was observed in all the patients; it was expressed in the quality of life increase according to the Minnesota Questionnaire (MLHFQ); in a decrease of heart failure grade according to NYHA, and tolerance growth to physical exercise during the treadmill test. The maximal effect, by the way, was developed in month and had been holding on during the 9-12 months. Thus if the quality of life before applying the transplantation of autologous MSC was 58+1,8 points; after the 3 months this rate was 32±2,2 points (by p<0,05); but after the I year, it was 37±2,1 points and was progressively decreased in the future. During the ultrasound imaging in the first group was mentioned decrease of left ventricle (LV) ejection fraction (EF) till 23,2±5,2% during the whole study; in the second group, it was observed an EF increase from 31,2±7,1 to 37,4±5,2% by p<0,05 and to the deadline of 6 months it began to decrease. In this period of time the patients reduced the doses of taken medicines; it was mentioned tolerance intensification to the physical exercises that we approved with the help of treadmill test. During the cardiac mapping with the help of navigation system CARTO XP we observed that in 6 months the amplitude of unipolar signal increased from 7,8-8,7 MB to 9,0-9,4 MB in the front-lateral zone; and from 5,3-12,0 to 7,9-14,1 MB in the b posteroseptal correspondingly; it tells about the improvement of electromechanical association and improvement of working function as well as myocardium perfusion. In three years during the control investigation, it was mentioned a negative dynamics in comparison with the baseline results. Conclusions. As we see, the first experience of intracoronary introduction of autologous MSC in patients with refractory angina pectoris showed the raise of myocardium functional reserve that was reflected in the improvement of life quality; reduction of antianginal agent doses; raise of LV EF; as well as in the amplitude of unipolar myocardium signal increase in the MSC introduction zone.
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Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».