Biological myocardial revascularization as a complementary therapy when combined with surgical myocardial revasculatization

Preliminary communication of a case and control prospective, randomized and double-blind study

  • Gabriel Lorier Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Servicio de Cirugía Cardíaca, Prof. Adjunto
  • Cristina Touriño Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Departamento Básico de Medicina, Profesora Agregada
  • Ismael Rodríguez Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Departamento de Hemoterapia, Profesor Agregado
  • Lilián Díaz Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Cátedra de Hematología, Profesora Agregada
  • Mariella Lujambio Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Cátedra de Cardiología, Profesora Adjunta
  • Silvia Mato Uruguay, Hospital Italiano, Servicio de Ecocardiografía, Cardióloga Ecografista
  • Rodolfo Ferrando Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Servicio de Medicina Nuclear, Profesor Adjunto
  • Alexandra Sujanov Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Departamento Básico de Medicina, Ex Ayudante
  • Daniel Leal Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Departamento Básico de Medicina, Asistente
  • Adriana Quagliata Universidad de la República, Facultad de Medicina, Departamento de Medicina Nuclear, Asistente
  • Luis Liguera Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Servicio de Cirugía Cardíaca, Residente
  • Víctor Dayan Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Servicio de Cirugía Cardíaca, Residente
  • Gabriel Parma Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Departamento de Cardiología, Residente
  • Martha Nese Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Cátedra de Hematología, Profesora
  • Jorge Decaro Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Departamento de Hemoterapia, Profesor
  • Álvaro Lorenzo Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Servicio de Cirugía Cardíaca, Profesor
  • Ricardo Roca Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Departamento Básico de Medicina, Profesor
Keywords: MYOCARDIAL ISCHEMIA, MYOCARDIAL REVASCULARIZATION, CELL THERAPY, BONE MARROW

Abstract

Introduction: incomplete surgical myocardial revascularization is a determining factor for early flare of subsequent angina which results in lower patient survival.
Objective: the present study aims to evaluate the perfusional efficacy of cell angiogenic therapy, using autologic bone-marrow derived stem cells, by means of direct intramyocardial injections, as a complementary therapy when combined with myocardial surgical revascularization.
Method: perfusional assessment subsequent to surgery is performed after three, six and twelve months with Single Photon Emission Computed Tomography (SPECT) and DTI-Strain.
Results: the present preliminary communication/notice (preceded by eight pilot cases) reports results obtained in four patients (two cases and two controls), completed follow-up in the third month, all of which evidenced chronic right coronary (RC) occlusion with no reversal, 50% average left ventricle ejection fraction. An average of 5.7 x 106 CD34+ autologic cells was injected into the descending posterior and posterolateral territory. The average injection volume was 5 ml per territory. Upon SPECT perfusional control in the third month, a 10% perfusional increase was detected in the injected territories. As to the control cases, nonrevascularized myocardial sectors evidenced a perfusional decrease of 3%, on average. DTI-Strain showed values improvement for all samples studied in the case of the preserved left ventricle ejection fraction (LVEF), and worsening in the LVEF lower range.
Angiogenic cell therapy by intramyocardial autologic bone-marrow stem cells implies perfusional benefits. It is a feasible and safe technique to complement surgical treatment.

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Published
2008-12-31
How to Cite
1.
Lorier G, Touriño C, Rodríguez I, Díaz L, Lujambio M, Mato S, Ferrando R, Sujanov A, Leal D, Quagliata A, Liguera L, Dayan V, Parma G, Nese M, Decaro J, Lorenzo Álvaro, Roca R. Biological myocardial revascularization as a complementary therapy when combined with surgical myocardial revasculatization. Rev. Méd. Urug. [Internet]. 2008Dec.31 [cited 2024Nov.17];24(4):246-5. Available from: http://www2.rmu.org.uy/ojsrmu311/index.php/rmu/article/view/518
Issue
Vol 24 No 4 (2008): Revista Médica del Uruguay
Section
Original Articles
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