RESUMO
BACKGROUND: Mesenchymal stem cells (MSCs), which have the potential to differentiate into cardiomyocytes or vascular endothelial cells, have been used clinically as therapy for cardiomyopathy. In this study, we aimed to evaluate the long-term follow-up results.MethodsâandâResults:We studied 8 patients with symptomatic heart failure (HF) on guideline-directed therapy (ischemic cardiomyopathy, n=3; nonischemic cardiomyopathy, n=5) who underwent intracardiac MSC transplantation using a catheter-based injection method between May 2004 and April 2006. Major adverse events and hospitalizations were investigated up to 10 years afterward. Compared with baseline, there were no significant differences in B-type natriuretic peptide (BNP) (from 211 to 173 pg/mL), left ventricular ejection fraction (LVEF) (from 24% to 26%), and peak oxygen uptake (from 16.5 to 19.2 mL/min/kg) at 2 months. During the follow-up period, no patients experienced serious adverse events such as arrhythmias. Three patients died of pneumonia in the 1st year, liver cancer in the 6th year, and HF in the 7th year. Of the remaining 5 patients, 3 patients were hospitalized for exacerbated HF, 1 of whom required heart transplantation in the 2nd year; 2 patients survived for 10 years without worsening HF. CONCLUSIONS: The results of this exploratory study of intracardiac MSCs administration suggest further research regarding the feasibility and efficacy is warranted.
Assuntos
Cardiomiopatias/terapia , Insuficiência Cardíaca/terapia , Transplante de Células-Tronco Mesenquimais , Adulto , Cateterismo Cardíaco , Cardiomiopatias/mortalidade , Intervalo Livre de Doença , Feminino , Seguimentos , Insuficiência Cardíaca/mortalidade , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Taxa de SobrevidaAssuntos
Doenças Vasculares Periféricas/cirurgia , Desenho de Prótese/efeitos adversos , Stents/efeitos adversos , Calcificação Vascular/cirurgia , Procedimentos Cirúrgicos Vasculares/métodos , Idoso de 80 Anos ou mais , Ligas , Angiografia/métodos , Artéria Femoral/patologia , Artéria Femoral/cirurgia , Humanos , Masculino , Artéria Poplítea/patologia , Artéria Poplítea/cirurgia , Desenho de Prótese/métodos , Resultado do Tratamento , Grau de Desobstrução Vascular , Procedimentos Cirúrgicos Vasculares/efeitos adversosRESUMO
An aortic mural thrombus (AMT) on a non-atherosclerotic wall is a rare but important cause of arterial thromboembolism. We herein report two cases of AMT in the thoracic aorta. Both showed multiple hypercoagulable factors (case 1: protein S deficiency and positive finding of anti-cardiolipin antibody; case 2: protein C deficiency, gastric cancer, and cisplatin-based chemotherapy) and were successfully treated with anticoagulation. Hypercoagulable states, including malignancy, can influence the formation of AMT; therefore, the accurate assessment of a hypercoagulable condition is necessary when we encounter patients with AMT.