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№1' 2019
SURGERYInternational Medical Journal, Vol. 25., Iss. 1, 2019, P. 27−30.
EFFECT OF CORD BLOOD STEM CELLS TRANSPLANTATION IN PATIENTS WITH DILATED CARDIOMYOPATHY ON ARRHYTHMIA DEVELOPMENT IN LONG-TERM PERIOD
"O. O. Shalimov National Institute of Surgery and Transplantology of the National Academy of Medical Sciences of Ukraine", Kyiv, Ukraine
Dilated cardiomyopathy (DCM) plays an important role among non−coronary heart diseases leading to the development of chronic heart failure. Transplantation of various types of stem cells improves the contractile function of the affected myocardium. Stem cells possess a proarrhythmogenic effect due to the impossibility of complete electromechanical integration of the transplanted cells with the recipient's myocardium, their delivery way and origin of the target substrate. To study the effect of cord blood stem cell transplantation in the patients with dilated cardiomyopathy on development of arrhythmias in the long−term period, 20 patients were examined, who were Holter−monitored daily at months 1, 3, 6, 12, 18. The choice of cord blood stem cells is associated with relative simplicity of their procurement, lack of risk for the donor, low contamination of neonatal cells with viruses, relatively low cost of transplantation. By the end of the prospective follow−up period (18 months) after transplantation of cord blood stem cells, a decrease in the relative number of high−gradation ventricular extrasystoles was recorded, being of an increased risk of fatal arrhythmological events from 40 to 17.6 % (class IVa) and from 45 to 11.9 % (class IVb) for Lown − Wolf (p < 0.05). The findings showed that the transplantation procedure itself did not increase the risk of ventricular extrasystoles. There were no adverse effects of cord blood stem cell transplantation, including proarrhythmogenesis, which may indicate the safety of this class of stem cells in the long−term observation period.
Key words: dilated cardiomyopathy, stem cells, heart failure, arrhythmia.