Safety and Efficacy of Intramyocardial Implantation of Peripheral Blood Stem Cell for Cardiomyopathy

Main Article Content

Permyos Ruengsakulrach, MD, PhD, FRCST, FCCP
Kittipan Visudharom, MD, PhD
Lertlak Chaothawee, MD
Michael Belkin, MD

Abstract

OBJECTIVE. To determine the safety and efficacy of intramyocardial autologous blood stem cell injection for cardiomyopathy.


MATERIALS AND METHODS. Between May 2005 and February 2010, 126 consecutive patients underwent intramyocardial cell injection. Fifty two were dilated cardiomyopathy (DCM) and 74 were ischemic cardiomyopathy (ICM). Mean age was 59.2 ± 12.4 years. The stem cells are isolated from the patient’s own blood and cultured. The final product is called angiogenic cell precursors (ACPs). The number of cells prior to injection was 46.1 ± 36.5 million cells. ACPs were injected into all areas of the left ventricle in DCM patients, and into the non-viable myocardium and hypokinetic segments in ICM patients. Combined coronary artery surgery and cell injection were performed in 33.8% of ICM cases.


RESULTS. There was no new ventricular arrhythmia. The 30-day mortality rate was 3.8% (2/52) and 4.1% (3/74) in DCM and ICM, respectively. New York Heart Association (NYHA) class improved from 3.0 ± 0.6 to 2.0 ± 0.9 at 485.8 ± 370.3 days (p < 0.001) in DCM and improved from 2.7 ± 0.6 to 1.9 ± 0.8 at 419.6 ± 345.5 days (p < 0.001) in ICM. Left ventricular ejection fraction (LVEF) increased from 23.3 ± 7.0% to 27.7 ± 11.3% at 409.7 ± 352.4 days (p = 0.03) in DCM and increased from 23.6 ± 7.7% to 31.5 ± 10.0% at 400.6 ± 350.1 days (p < 0.001) in ICM. Quality of life evaluated at 3 months has significantly improved for physical function, rolephysical, general health and vitality domains in DCM. For ICM, physical function, role-physical, general health and social function domains were also improved.


CONCLUSION. Intramyocardial ACPs injection is feasible and safe in both DCM and ICM. NYHA, quality of life and LVEF had significantly improved in both DCM and ICM.

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1.
Ruengsakulrach P, Visudharom K, Chaothawee L, Belkin M. Safety and Efficacy of Intramyocardial Implantation of Peripheral Blood Stem Cell for Cardiomyopathy. BKK Med J [Internet]. 2011Sep.20 [cited 2020Jul.15];2(1):19. Available from: https://he02.tci-thaijo.org/index.php/bkkmedj/article/view/217713
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