УДК 616.-089.843
A.U. Dzholdasbekova, G.V. Fedotovskih, M.B. Askarov, B.G. Kupenov,
B.A. Komsabakova, A. Baigenzhina, A.K. Kairatova, G.U. Abilkasimova,
D.M. Zakarina, B.A. Dzjandosova, I.A. Vydrina
JSC "National Scientific Medical Center", Astana c., Kazakhstan
SYSTEMIC RETRANSPLANTATION OF AUTOLOGOUS BONE
MARROW DERIVED MONONUCLEAR CELLS FOR HEART FAILURE:
REPORT OF SAFETY AND EFFICACY
Regenerative medicine with using autologous bone marrow derived stem cells (BMSC) has emerged a promising approach.
Purpose of the study. Heart failure (HF) is the major cause of death worldwide. Despite the available pharmacotherapy, prognosis is usually harsh. Here we assessed the safety and efficacy of autologous bone marrow-derivedmononuclear cell (BMMC) retransplantation in HF (left ventricular ejection fraction, LVEF <45%).
Material and methods. A whole number of 104 patients were included to the study (male=84 and female=20), age 27 untill 65 with Heart failure. All patients underwent standard examination (12-lead ECG, echocardiography, 6-minute walking test and laboratory tests).
After systemic BMMC retransplantation, EF was shown to rise at 12 months for both DCMP and ISCM (32,1±1,3 vs 41,3±1,6% and 32,2±1,2% vs 39,3±2,6%, respectively; p-value <0,005). ProBNP recognized as an early marker of HF tend to reduce sufficiently by 3 monthsand continued to recover at one-year follow-up for both diseases (3266, ±344,4 vs 361±35,9 ng/ml; p-value <0,0001 and 4618±267 vs 286±35,9 ng/ml; p-value<0,0001 for ICMP and DCMP, respectively).
In conclusion, these results suggest BMMC transplantation is safe and well tolerated. BMMC infusion has improved systolic myocardial function, and a consequence has delayed the progression of HF, which is confirmed by recovering proBNP. Moreover, BMMC transplantation might favor by preliminarycell cultivation due to enhanced mitochondrial function.
Conclusion. Taken as a whole, BSMSC retranplantation has proven to be safe and well tolerated. No patient diagnosed with tumour, immune rejection, acute inflammation and worsening cardiac events. BMSC reinfusion was shown to improve systolic myocardial function, and as a result to slow down the progression of HF, which is confirmed by recovering proBNP known as an early marker of HF. What is more, it is now possible to enhance the mitochondrial function by preliminary BMSC cultivation, especially, by using antioxidative agents such as phosphocreatine.
Key words: stem cells, heart failure, bone marrow, ischemic cardiomyopathy. dilated cardiomyopathy.