Варианты использования клеточной кардиомиопластики при ишемической болезни сердца

Background. Despite a significant arsenal of medications and methods of surgical correction of myocardial blood supply, treatment of some forms of coronary heart disease remains relevant. Aim of the work is to analyze the effectiveness of the use of mesenchymal stem cells (МSC) of bone marrow in autologous transendocardial transplantation in some forms of IHD. Methods. In the near and long-term results, we analyzed the histories and diseases and conducted a survey of 68 patients. Of the 68 patients, the largest group was men - 53 (77.9%), women were much fewer - 15 (22.1%). Then we formed 4 groups (17 patients each): 1 group - control - patients received standard drug therapy; Group 2 - to patients who received standard therapy, empty myocardial injections were performed using a catheter and the NOGA XP navigation system; Group 3 - auto-CCK was administered intravenously to patients; 4 group - against the background of therapy, transendocardial auto-МSС was administered. Results. When analyzing the patient’s subjective sensations in group I, after 3 months in group 1, 4 patients (32%) noted improvement, unchanged - 11 (64.7%), worsening - 2 (11.8%) and significant worsening 1 (5.9%). In group 2, improvement was in 1 patient, which was 5.9%, unchanged - 13 (76.5%), worsening - 2 (11.8%) and significant deterioration - 2 (11.8%). In group 3, improvement was observed in 5 patients - 29.4%, significant improvement in 1 (5.9%), deterioration and significant deterioration in 1 patient (5.9% each, respectively). In group 4 unchanged - 6 (35.3%) patients, improvement - 7 (41.2%), significant improvement - 4 (32%), worsening - 1 (5.9%). Cell transplantation, regardless of the method of administration, increases the EF and reduces the EDV of the left ventricle, more significantly in the group with a transendocardial route of administration. Conclusion. In accordance with published data, we obtained similar data - transplantation of human bone marrow SSC with autologous administration causes a positive effect in the form of increased EF LV, decreased EDV of the LV, increased exercise tolerance and a significant improvement in patients’ well-being. It should be noted that intravenous and intracoronary administration of auto-МSC is less effective in the studied parameters than transendocardial introduction of cells into the myocardium.