Abstract:

AIM： The safety and efficiency of intracoronary transplantation of autologous blood stem cells in old patients with heart failure after acute myocardial infarction were investigated. METHODS： Seven old patients （average age of 69 years） with heart failure after acute myocardial infarction were selected, who received intracoronary transplantation of autologous mononuclear bone marrow cells in Department of Cardiology, Subei People＇s Hospital of Jiangsu Province from June 2004 to June 2006. Their heart function was grade Ⅲ to Ⅳ and left ventricle ejection fraction 〈 50%. They were treated with intracoronary transplantation of autologous blood stem cells besides medication. Of them, bone marrow stem cells of 2 cases were amplified in vitro, and stem cell suspension of 5 cases was isolated from peripheral blood after granulocyte colony-stimulating factor （G-CSF） injection. The mononuclear cells were transferred into the infarction-related artery by occluding the over the wire balloon and infusing artery through balloon center lumen. The adverse effects during stem cell mobilization, culture, collection and transfusion were observed. Changes in the morphology, heart function, wall motion integral index and 6-minute walking distance were evaluated by echocardiogram （ECG） before transplantation and 3 and 6 months thereafter. RESULTS： Seven patients were all involved in the result analysis. Three months after operation, the heart function was improved. No obvious changes in contraction inner diameter and ejection fraction were found in ECG; although 6-minute walking distance was increased, there was no significant difference （P 〉 0.05）. Six months after transplantation, the heart function of patients was remarkably improved, and the contraction inner diameter and ejection fraction were also improved significantly in ECG （P 〈 0.05）; 6-minute walking distance was increased （P 〈 0.05）. No severe side effects ware observed during transplantation. CONCLUSION： Autologous intracoronary transplantation is a safe and feasible treatment for old patients with heart failure after acute myocardial infarction. The left ventricular function is improved by ECG at 6 months.[著者文摘]