Short-term and long-term results of intracoronary introduction of autologous mesenchymal stem cells in exertional angina pectoris
Bibliographic record
Abstract
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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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".