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Improvement of symptoms and ejection fraction in
patients with advanced ischemic cardiomyopathy
treated with autologous bone marrow mononuclear
cells by retrograde coronary infusion
Márcio Balbinotti Rogério Sarmento-Leite
Alexandre Quadros Renato Kalil Nance Nardi
Paulo Salgado James Fracasso Maurício Marques
Carlos M. Gottschall
MRI
Functional class
INTRODUCTION Ischemic cardiomyopathy is the most
frequent cause of heart failure, and is
associated to high mortality. Cell therapy
represents an interesting alternative to
refractory and end stage cases. Several cell
types, with different routes of administration
have been investigated. This study aimed at
evaluating the effects of autologous bone marrow
mononuclear cells, administered by retrograde
coronary infusion, on chronic ischemic
cardiomyopathy.
p 0,059
p 0,31
p 0,042
Wilcoxon-mann-whitney

• Pilot, prospective and non-randomized (6
  patients)
• Advanced chronic symptomatic coronary disease,
  receiving complete pharmacological treatment
• Reduced segmentary contractility of the left
  ventricle anterior wall, with demonstrable
  reversible ischemia (viability) by MRI.
• Not candidates to conventional techniques of
  myocardial revascularization
• In average, 108 cells were infused through the
  lumen of a over-the-wire balloon catheter
  advanced in the anterior cardiac vein
• No complications related to the procedure were
  observed.

p 0,06
p 0,34
Wilcoxon-mann-whitney

• CONCLUSIONS
• The administration of autologous bone marrow
  mononuclear cells by retrograde coronary infusion
  to patients with advanced symptomatic coronary
  disease, and not candidate to conventional
  therapies, are safe and resulted in improved
  functional class and regional and global
  myocardial contractility. Further investigations
  through randomized clinical trials are needed to
  test this technique in large scale.

Instituto de Cardiologia do Rio Grande do Sul -
Porto Alegre, RS - Brazil