Management of Idiopathic Dilated Cardiomyopathy with Intramyocardial Stem Cell Transplantation in Children: A Retrospective Study of 7 Patients
Science Journal of Clinical Medicine
Volume 2, Issue 4, July 2013, Pages: 129-133
Received: Jun. 21, 2013; Published: Jul. 10, 2013
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Authors
Aris Lacis, Clinic of Pediatric Cardiology and Cardiac Surgery, University Children Hospital, Riga, Latvia
Inguna Lubaua, Riga Stradins University, Riga, Latvia
Andrejs Erglis, Latvian Institute of Cardiology, Riga, Latvia
Andis Lacis, Riga Stradins University, Riga, Latvia
Inta Bergmane, Clinic of Pediatric Cardiology and Cardiac Surgery, University Children Hospital, Riga, Latvia
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Abstract
This retrospective report presents findings on 7 patients with idiopathic dilated cardiomyopathy who underwent transplantation of autologous bone marrow derived mononuclear cells (BMSC) after failed routine conservative treatment, and were on a waiting list for cardiac transplantation. In two out of seven patients, we performed intramyocardial delivery of BMSC twice, 22 and 24 months respectively after the first transplant. All patients received anti-congestive therapy by diu-retics, ACE inhibitors, carvedilol, digitalis and aspirin. We discuss potential disadvantages of intracoronary injections of autologous bone marrow stem cells. We believe that our BMSC transplantation method as opposed to intravascular input is the method of choice, particularly in children with idiopathic dilated cardiomyopathy because it is safe, gentle and is not associated with risks for coronary circulation.
Keywords
Idiopathic Dilated Cardiomyopathy (IDCM) In Children, Bone Marrow Stem Cells (BMSC), Intramyocardial BMSC Transplantation
To cite this article
Aris Lacis, Inguna Lubaua, Andrejs Erglis, Andis Lacis, Inta Bergmane, Management of Idiopathic Dilated Cardiomyopathy with Intramyocardial Stem Cell Transplantation in Children: A Retrospective Study of 7 Patients, Science Journal of Clinical Medicine. Vol. 2, No. 4, 2013, pp. 129-133. doi: 10.11648/j.sjcm.20130204.12
References
[1]
Alvarez J., Wilkinson J. D., Lipshultz S. E. The Pediatric Cardiomiopathy Registry Study Group. Outcome predictors for pediatric dilated cardiomyopathy: A systemic review. Prog Pediatr Cardiol, 2007:25–32.
[2]
Arola A., Tuominen J., Ruuskanen O., Jokinen E. Idiopathic dilated cardiomyopathy in children: prognostic indicators and outcome. Pediatrics, 1998; 101(3 Pt 1):369–76.
[3]
Rupp S., Bauer J., Tonn T., et al. Intracoronary administration of autologous bone marrow-derived progenitor cells in a critically ill two-yr-old child with dilated cardiomyopathy. Pediatr Transplant, 2009;13(5):620–3.
[4]
Limsuwan A., Hongeng S., Khowsathit P., et al. Transcoronary bone marrow-derived mononuclear progenitor cells. Cardiol Young, 2010;20,Suppl 1:336.
[5]
Olguntürk R., Kula S., Sucak G. T., et al. A. Peripheric stem cell transplantation in children with dilated cardiomyopathy: preliminary report of first two cases. Pediatr Transplant, 2010;14(2):257–60.
[6]
Rivas J., Menedez J. J., Arrieta R., et al. Usefulness of intracoronary therapy with progenitor cells in patients with dilated cardiomyopathy: Bridge or alternative to heart transplantation. Anales de pediatria, 2011;74(4):218–25.
[7]
Menasche P., Hagege A. A., Scorsin M., et al. Myoblast transplantation for heart failure. Lancet, 2001;357:279–80.
[8]
Hamano K., Nishida M., Hirata K., et al. Local implantation of autologous bone marrow cells for therapeutic angiogenesis in patients with ischemic heart disease: clinical trial and preliminary results. Jpn. Circ. J., 2001;65:845–7.
[9]
Stamm C., Westphal B., Kleine H. D., et al. Autologous bone-marrow stem cell transplantation for myocardial regeneration. Lancet, 2003;361:45–6.
[10]
Tse H. F., Kwong Y. L., Chan J. K., et al. Angiogenesis in ischemic myocardium by intramyocardial autologous bone marrow mononuclear cell implantation. Lancet, 2003;361:47–9.
[11]
Smits P. C., van Geuns R. J., Poldermans D., Bountioukas M. Catheter-based intramyocardial injection of autologous skeletal myoblasts as a primary treatment of ischemic heart failure: Clinical experience with six-month follow-up. J. Am. Coll. Cardiology, 2003;42:2063–9.
[12]
Perin E. C., Dohmann H. F., Borojevic R., et al. Transendocardial, autologous bone marrow cell transplantation for severe chronic ischemic heart failure. Circulation, 2003; 107:2294–2302.
[13]
Minami K., von Knyphausen E., Niino T., et al. Long-term results of pediatric heart transplantation. Ann Thorac Cardiovasc Surg, 2005 Dec;11(6):386–90.
[14]
Towbin J. A. Cardiomyopathy and heart transplantation in children. Curr Opin Cardiol, 2002;17(3):274–9.
[15]
Lindenfeld J., Kelley P. A. The mechanical heart in Felix B. Engeli "Heart regeneration",pp.270–92. World Scientific Publ. Co Pte. Ltd. 2012. Singapore.
[16]
Pauliks L. B., Undar A. New devices for pediatric circulatory support. Curr Opin Cardiol, 2008;23(2)91–6.
[17]
ESC guidelines for the diagnosis and treatment of acute and chronic heart failure. 2008.
[18]
Cowley C. G., Lozier J. S., Orsmond G. S., Shaddy R. E. Safety of endomyocardial biopsy in children. Cardiol Young, 2003 Oct;13(5):404–7.
[19]
Kuhn H., Lawrenz T., Beer G. Indication for myocardial biopsy in myocarditis and dilated cardiomyopathy. Med Klin (Munich), 2005 Sep 15;100(9):553–61.
[20]
Lacis A., Erglis A. Intramyocardial administration of autologous bone marrow mononuclear cells in a critically ill child with dilated cardiomyopathy. Cardiology in the Young,2011,21,110–12.
[21]
Lacis A., Bergmane I., Ozolins V., et al. Preliminary results of using stem cells transplantation for pediatric patients in case of dilated cardiomyopathy. A Cardiovascular Multimedia Journal, 2010,13, Suppl.2, p.117.
[22]
Murry C.E., Soonpaa M.H., Reinecke H., Nakajima H., Nakajima H.O., Rubart M., et al. Haematopoietic stem cells do not transdifferentiate into cardiac myocytes in myocardial infarcts. Nature, 2004;428(6983):664–8.
[23]
Heil M., Ziegelhoeffer T., Mees B., Schaper W. A different outlook on the role of bone marrow stem cells in vascular growth: bone marrow delivers software not hardware. Circ Res, 2004;94(5):573–4.
[24]
Taghavi S., George J.C. Homing of stem cells to ischemic myocardium. Am J Transl Res, 2013; 5(4): 404–11.
[25]
Bodine D., Seidel N., Gale M., et al. Efficient retrovirus transduction of mouse pluripotent hematopoietic stem cells mobilized into the peripheral blood by treatment with granulocyte colony-stimulating factor and stem cell factor. Blood, 1994;84:1482–91.
[26]
Shintani S., Murohara T., Ikeda H., et al. Mobilization of endothelial progenitor cells in patients with acute myocardial infarction. Circulation, 2001;103:2776–9.
[27]
Meloni M., Caporali A., Graiani G. et al. Nerve growth factor promotes cardiac repair following myocardial infarction. Circulation Research, 2010;106:1275–84.
[28]
Zohlnhofer D., Ott I., Mehilli J., et al. Stem cell mobilization by granulocyte colony-stimulating factor in patients with acute myocardial infarction. JAMA, 2006;295:1003-10.
[29]
Rota M., Padin-Iruegas M.E., Misao Y., et al. Local activation or implantation of cardiac progenitor cells rescues scarred infarcted myocardium improving cardiac function. Circ Res, 2008;103:107–16.
[30]
Urbanek K., Rota M., Cascapera S, et al. Cardiac stem cells possess growth factor-receptor systems that after activation regenerate the infarcted myocardium, improving ventricular function and long-term survival. Circ Res, 2005;97:663–73.
[31]
Wang Y., Johnsen H.E., Mortensen S., et al. Changes in circulating mesenchymal stem cells, stem cell homing factor, and vascular growth factors in patients with acute ST elevation myocardial infarction treated with primary percutaneous coronary intervention. Heart, 2006;92:768–74.
[32]
Aicher A., Heeschen C., Mildner-Rihm C., et al. Essential role of endothelial nitric oxide synthase for mobilization of stem and progenitor cells. Nat Med, 2003 Nov;9(11):1370-6.
[33]
Westenbrink B.D., Lipsic E., Van der Meer P., et al. Erythropoietin improves cardiac function through endothelial progenitor cell and vascular endothelial growth factor mediated neovascularization. Eur Heart J, 2007;28:2018–27.
[34]
Schächinger V., Aicher A., Döbert N., et al. Pilot trial on determinants of progenitor cell recruitment to the infarcted human myocardium. Circulation, 2008 Sep 30; 118(14):1425-32.
[35]
Schots R., De Keulenaer G., Schoors D., et al. Evidence that intracoronary-injected CD133+ peripheral blood progenitor cells home to the myocardium in chronic postinfarction heart failure. Exp Hematol, 2007 Dec; 35(12):1884-90.
[36]
De Rosa S., Seeger F.H., Honold J., et al. Procedural safety and predictors of acute outcome of intracoronary administration of progenitor cells in 775 consecutive procedures performed for acute myocardial infarction or chronic heart failure. Circ Cardiovasc Interv, 2013 Feb; 6(1):44-51.
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