Treatment of a patient with dilated cardiomyopathy using mesenchymal stem cells
Article Sidebar
Main Article Content
Abstract
Dilated cardiomyopathy (DCM) is a common disease with a pessimistic prognosis. Heart transplantation is a radical method of treating DCM patients with severe chronic heart failure. But given the lack of donor organs, the development of new methods for the treatment of DCM is relevant. The use of stem cells in the complex treatment of patients with DCM according to the literature improves the results of treatment and is associated with an improvement of the systolic function of the left ventricle and normalization of the diastolic function of the left ventricle, a decrease of the functional class of CHF and an improvement of the life quality of such patients. The article presents a 3-year observation of a patient with dilated cardiomyopathy, who received cord blood mesenchymal stem cells as a treatment. Patient’s dilated cardiomyopathy was developed after a severe chronic myocarditis. The patient was examined by clinical and instrumental methods, including echocardiography, cardiac MRI with gadolinium contrast, ECG Holter monitoring, BNP study, 6-minute gait test, and the patient’s quality of life was assessed according to the Minnesota questionnaire. The prescribed drug therapy included torasemide at a dose of 20–10 mg/day, spironolactone at a dose of 25 mg/day, carvedilol 6.25 mg/day, ramipril 1.25 mg/day, dapagliflozin 10 mg/day, amiodarone 200 mg/day. After 5 months of drug therapy, a more significant effect was not observed. The patient was injected intravenously with a cell preparation of donor umbilical cord blood. During the study, there was a positive dynamic of the clinical condition, improvement of the contractile function of the left ventricle, improvement of the life quality. The patient was taken off the waiting list for a heart transplant. Patient’s observation continues.
Article Details
Keywords:
References
Alestalo K, Miettinen JA, Vuolteenaho O, Huikuri H, Lehenkari P. Bone marrow mononuclear cell transplantation restores inflammatory balance of cytokines after ST segment elevation myocardial infarction. PLOS ONE. 2015;10(12): e0145094. DOI: https://doi.org/10.1371/journal.pone.0145094.
Braunwald E. Cardiomyopathies: an overview. Circ Res. 2017;121(7):711-21. DOI:https://doi.org/10.1161/CIRCRESAHA.117.311812.
Hodgkinson CP, Bareja A, Gomez JA, Dzau VJ. Emerging concepts in paracrine mechanisms in regenerative cardiovascular medicine and biology. Circ Res. 2016;118(1):95-107. DOI: https://doi.org/10.1161/CIRCRESAHA.115.305373.
Karantalis V, Balkan W, Schulman IH, Hatzistergos KE, Hare JM. Cell-based therapy for prevention and reversal of myocardial remodeling. Am J of Physiol Heart Circ Physiol. 2012;303(3):H256-70. DOI: https://doi.org/10.1152/ajpheart.00221.2012.
Krejci J, Mlejnek D, Sochorova D, Nemec P. Inflammatory cardiomyopathy: a current view on the pathophysiology, diagnosis, and treatment. BioMed Res Intern. 2016;2016:4087632. DOI: https://doi.org/10.1155/2016/4087632.
Lu Y, Wang Y, Lin M, Zhou J, Wang Z, Jiang M et al. A systematic review of randomised controlled trials examining the therapeutic effects of adult bone marrow-derived stem cells for non-ischaemic dilated cardiomyopathy. Stem Cell Res Ther. 2016;7(1):186. DOI: https://doi.org/10.1186/s13287-016-0441-x.
Martin-Rendon E. Meta-Analyses of human cell-based cardiac regeneration therapies response to Martin-Rendon: What can systematic reviews tell us about cell therapies for ischemic heart disease? Circ Res. 2016;118(8):1264-72. DOI: https://doi.org/10.1161/CIRCRESAHA.115.307540.
McKenna WJ, Maron BJ, Thiene G. Classification, epidemiology, and global burden of cardiomyopathies. Circ Res. 2017;121(7):722–30. DOI: https://doi.org/10.1161/CIRCRESAHA.117.309711.
Merlo M, Caiffa T, Gobbo M, Adamo L, Sinagra G. Reverse remodelingin dilated cardiomyopathy: insights and future perspectives. IJC Heart & Vasculature. 2018;18:52-7. DOI: https://doi.org/10.1016/j.ijcha.2018.02.005.
Poglajen G, Zemljič G, Frljak S, Cerar A, Andročec V, Sever M. et al. Stem cell therapy in patients with chronic nonischemic heart failure. Stem Cells Intern. 2018;2018:6487812. DOI: https://doi.org/10.1155/2018/6487812.
Sanchez-Trujillo L, Vazquez-Garza E, Castillo EC, Garcia-Rivas G, Torre-Amione G. Role of adaptive immunity in the development and progression of heart failure: new evidence. Arch Med Res. 2017;48(1):1-11. DOI: https://doi.org/10.1016/j.arcmed.2016.12.008.
Tokita Y, Tang X-L, Li Q, Wysoczynski M, Hong KU, Nakamura S. et al. Repeated administrations of cardiac progenitor cells are markedly more effective than a single administration: a new paradigm in cell therapy. Circ Res. 2016;119(5):635-51. DOI: https://doi.org/10.1161/CIRCRESAHA.116.308937.
Wysoczynki M, Khan A, Bolli R. New paradigms in cell therapy: repeated dosing, intravenous delivery, immunomodulatory actions, and new cell types. Circ Res. 2018;123(2):138-58. DOI: https://doi.org/10.1161/CIRCRESAHA.118.313251.