Quality of life of CHD patients with normal and moderately lowered left ventricular ejection fraction before and after endomyocardial cellular cardiomyoplasty

Aim. Evaluation of quality of life of coronary heart disease (CHD) patients with normal and lowered left ventricular ejection fraction (LVEF) treated by endomyocardial implantation of autologous bone marrow mononuclear cells (ABMMCs) by using the NOGA cardiac navigation system in combination with modern drug therapy.
Materials and methods. CHD patients (n=48) were divided into two groups according to their initial LVEF: group I patients had LVEF ≥ 50% (n = 30), while in group II it was 36–49% (n = 18). All patients underwent endomyocardial implantation of ABMMCs combined with modern drug therapy of CHD. Bone marrow aspiration to obtain ABMMC was performed from the iliac crest under regional anesthesia on the day of cell implantation according to a standard technique. Another option for obtaining ABMMCs was isolation from peripheral blood after administration of recombinant human granulocyte colony-stimulating factor (GCSF) (Grasalva, Israel). Each ischemic segment of the myocardium got 10 injections of cells of 0.2 ml volume. The average number of autologous cells injected into every patient was 41 ± 16 × 10⁶. The fraction of CD34/CD45-positive cells amounted to 2.5 ± 1.6%. Quality of life was evaluated using the SF-36 Health Survey at all stages of control (baseline, 6 months, 1 year and 3 years).
Results. No intraoperative complications were observed in both groups. The patients were discharged from the hospital on 3^rd–5^th day. At all stages of control all studied indicators of quality of life demonstrated a statistically significant improvement in relation to the baseline data in patients of both groups. As for complete functional relationship (W), the most significant parameters were as follows: PF (Physical Functioning) (W = 0.54), RE (Role-Emotional) (W = 0.72), SF (Social Functioning) (W = 0.48).
Conclusion. Endomyocardial implantation of ABMMCs supported by modern drug therapy facilitates the parameters of quality of life improvement in CHD patients with normal and moderately lowered LVEF during 3-year follow-up irrespective of its baseline value.

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