摘要

Para evaluar la efectividad del transplante de c谷lulas madre en pacientes con infarto del miocardio e insuficiencia card赤aca cr車nica severa mediante t谷cnicas de cardiolog赤a nuclear, se estudiaron 15 pacientes revascularizados: nueve (grupo I) recibieron c谷lulas madre aut車logas de m谷dula 車sea. Los 6 restantes correspondieron al grupo II (controles). Se les realiz車 evaluaci車n cl赤nica, ventriculograf赤a radioisot車pica y gammagraf赤a de perfusi車n con SPECT-gatillado (tecnecio-99m MIBI; protocolo de dos d赤as: dipiridamol 每 reposo), antes y tres meses despu谷s del proceder. A los tres meses hubo mejor赤a cl赤nica en el 89% de los pacientes del grupo I. La fracci車n de eyecci車n de ventr赤culo izquierdo aument車: de 32㊣9% a 44㊣13% (p=0.03; grupo I) y de 38㊣2% a 48㊣14% (p NS; grupo II). La velocidad m芍xima de llenado se increment車 de 120㊣11 a 196㊣45 VTD/seg (p=0.03; grupo I). El score sumado del dipiridamol disminuy車 significativamente s車lo en el grupo I (de 35㊣5 a 23㊣14; p=0.02). La mejor赤a de la perfusi車n estuvo relacionada con el sitio de implante en el 60% de los casos.Concluimos que el transplante de c谷lulas madre de m谷dula 車sea es efectivo en pacientes con insuficiencia card赤aca cr車nica severa de etiolog赤a isqu谷mica.With the aim of assessing the efficacy of bone marrow-derived stem cells transplantation in patients with myocardial infarction and severe chronic heart failure through nuclear cardiology techniques, 15 revascularized patients were studied: nine (Group I) received autologous bone marrow-derived stem cells. The other six were controls (Group II). All underwent a clinical evaluation, radionuclide ventriculography, and gated-SPECT myocardial perfusion scintigraphy (MIBI-technetium99m, two-day protocol: dipyridamole 每 rest), before and three months after the procedure. At three months there was a clinical improvement in 89% of patients from Group I. The left ventricular ejection fraction increased: from 32㊣9% to 44㊣13% (p=0.03; Group I) and from 38㊣2% to 48㊣14% (p NS; Group II). The peak filling rate improved from 120㊣11 to 196㊣45 EDV/sec (p=0.03; Group I). The dipyridamole summed score diminished significantly only in Group I (from 35㊣5 to 23㊣14; p=0.02). The perfusion improvement was related to the implantation site in 60% of cases. We conclude that the bone marrow-derived stem cells transplantation is effective in patients with severe chronic heart failure of ischemic origin.

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