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Abstract

BACKGROUND:

Many animal experiments and clinical trials have demonstrated that stem cell transplantation can improve heart function and reduce ventricular dilatation and ventricular remodeling, which has shown an incomparable superiority over traditional therapies in the treatment of myocardial infarction complicated by heart failure.

OBJECTIVE:

To observe the clinical effects of single autologous peripheral blood stem cell transplantation in acute myocardial infarction patients with heart failure.

METHODS:

Since 2006 August to 2010 June, 23 patients who were diagnosed to have acute ST elevation myocardial infarction complicated with heart failure were selected and divided into two groups: cell transplantation group (n=11) and control group (n=12). All patients underwent emergency coronary angiography and percutaneous coronary intervention with drug eluting stent implantation. In the stem cell transplantation group, peripheral blood stem cells positive for CD34 (about 1 ×108) were collected mobilized by granulocyte colony stimulating factor at 5 days after stent implantation, and then the cells were injected into infarcted vessels using coronary angiography method. Two-year follow-up was performed after cell transplantation to observe the cardiac function and adverse reactions in patients.

RESULTS AND CONCLUSION:

After 6 months of follow-up, the cardiac function in the cell transplantation group was improved significantly compared with that before cell transplantation (P < 0.05), and the left ventricular ejection fraction was increased by (6.2 ±0.2)% and the left ventricular end diastolic volume was reduced by (4.7 ±2.9) mm. However, there was no difference in follow-up results by the end of 1 and 2 years after cell transplantation (P > 0.05), as well as no adverse reaction occurred. In the control group, after 6 months of follow-up, the left ventricular ejection fraction was reduced by (0.5 ±0.1)% and the left ventricular end diastolic volume was increased by (0.4 ±0.3) mm, which were deteriorated year after year. Percutaneous coronary intervention with autologous peripheral blood stem cell transplantation can significantly improve the left ventricular function, reduce left ventricular volume, and delay or prevent left ventricular remodeling in patients with acute myocardial infarction, which is safe and effective. But up to 2 years after cell transplantation, the cardiac function shows no further improvement.

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