Journal Home > Volume 2 , Issue 1
Aim:

To investigate the effect of combined treatment with the inclusion of fetal stem cells (FSCs) on the morphology and functional dynamics of the left ventricle and cognitive functions in patients with chronic heart failure (CHF).

Materials and methods:

A comparative study was carried out on patients with CHF to examine the effect of combined treatment, including the experimental application of FSCs, on the morphofunctional parameters of the left ventricle and cognitive functions. Patients were examined before FSC treatment (FSCT), and 1 month, 3 months, and 6 months after treatment. The control group consisted of 20 CHF patients of similar age, sex, and New York Heart Association class.

Results:

It has been proven that FSCs positively affect objective and subjective clinical parameters. A significant reduction of serum type B brain natriuretic peptide was reported as early as 1 month after treatment. Significant increases in the left ventricle ejection fraction and decreases of the end diastolic volume were observed 6 months after treatment. Cognitive performance tests showed improvements on the Mini-Mental State Examination and Frontal Assessment Battery (conceptualization, mental flexibility, programming, sensitivity to interference, inhibitory control, and environmental autonomy) scales. The treatment resulted in significant improvements in the general score and across all cognitive areas of the Mini-Mental State Examination (recall, orientation, attention, calculation, and complex commands) after 3 months, and significant improvements across all Frontal Assessment Battery areas after 6 months. In the control group, these scores showed significant increases only at 6 months after the treatment. In the study group, depression was significantly reduced within 1 month after treatment versus 3 months in the control group. In both groups, reactive anxiety levels dropped after month 3 upon FSCT. FSCT resulted in statistically significant improvements in the contractile activity of the left ventricular myocardium, in cognitive functions, and in the emotional state of CHF patients.

Conclusion:

The evidence for significant improvements in the contractile function of the left ventricle myocardium, as well as in patients’ cognitive and emotional states, was observed in CHF patients after combined treatment with FSC.


menu
Abstract
Full text
Outline
About this article

Fetal stem cells in combined treatment of chronic heart failure and their effect on morphofunctional parameters of the left ventricle myocardium and cognitive functions

Show Author's information Mariya O Klunnyk( )Nataliia S SychIrina G MatiyashchukOlena V IvankovaMarina V Skalozub
Cell Therapy Center EmCell, Kyiv, Ukraine

Abstract

Aim:

To investigate the effect of combined treatment with the inclusion of fetal stem cells (FSCs) on the morphology and functional dynamics of the left ventricle and cognitive functions in patients with chronic heart failure (CHF).

Materials and methods:

A comparative study was carried out on patients with CHF to examine the effect of combined treatment, including the experimental application of FSCs, on the morphofunctional parameters of the left ventricle and cognitive functions. Patients were examined before FSC treatment (FSCT), and 1 month, 3 months, and 6 months after treatment. The control group consisted of 20 CHF patients of similar age, sex, and New York Heart Association class.

Results:

It has been proven that FSCs positively affect objective and subjective clinical parameters. A significant reduction of serum type B brain natriuretic peptide was reported as early as 1 month after treatment. Significant increases in the left ventricle ejection fraction and decreases of the end diastolic volume were observed 6 months after treatment. Cognitive performance tests showed improvements on the Mini-Mental State Examination and Frontal Assessment Battery (conceptualization, mental flexibility, programming, sensitivity to interference, inhibitory control, and environmental autonomy) scales. The treatment resulted in significant improvements in the general score and across all cognitive areas of the Mini-Mental State Examination (recall, orientation, attention, calculation, and complex commands) after 3 months, and significant improvements across all Frontal Assessment Battery areas after 6 months. In the control group, these scores showed significant increases only at 6 months after the treatment. In the study group, depression was significantly reduced within 1 month after treatment versus 3 months in the control group. In both groups, reactive anxiety levels dropped after month 3 upon FSCT. FSCT resulted in statistically significant improvements in the contractile activity of the left ventricular myocardium, in cognitive functions, and in the emotional state of CHF patients.

Conclusion:

The evidence for significant improvements in the contractile function of the left ventricle myocardium, as well as in patients’ cognitive and emotional states, was observed in CHF patients after combined treatment with FSC.

Keywords: heart failure, cognitive, emotional impairment, fetal stem cells, left ventricle remodeling

References(34)

1.
Zakharov VV, Yakhno NN. [Moderate cognitive impairment in the elderly: diagnostics and treatment]. Russian Medical Journal. 2004;10:573–576. Russian.
2.
Levin OS. Dyscirculatory encephalopathy: modern knowledge about development mechanisms and treatment. Consilium Medicum. 2007;8:72–79.
3.
Enright PL, Sherill DL. Reference equations for the six-minute walk in healthy adults. Am J Respir Crit Care Med. 1998;158(5 Pt 1):1384–1387.
4.
Robbins MA, O’Connell JB. Economic impact of heart failure in management of end-stage heart disease. In: Rose EA, Stevenson LW, editors. Management of End-Stage Heart Disease. Philadelphia, PA: Lippincott-Raven; 1998:3–11.
5.
Wang JS, Shum-Tim D, Chedrawy E, Chiu RC. The coronary delivery of marrow stromal cells for myocardial regeneration: pathophysiologic and therapeutic implications. J Thorac Cardiovasc Surg. 2001;122(4):699–705.
6.
Ostroumov EN, Yermolenko AE, Gureev SV, et al. [Right ventricle ejection fraction as myocardium revascularisation efficiency marker in ischemic heart disease with congestive circulatory failure]. Cardiology. 1996;4:57–61. Russian.
7.
Pullicino PM, Hart J. Cognitive impairment in congestive heart failure?: Embolism vs hypoperfusion. Neurology. 2001;57(11):1945–1946.
8.
Petrenko AY, Khunov YA, Ivanov YN. Stem Cells. Properties and Clinical Perspectives. Luhansk, Ukraine: Press Express; 2001:224–239.
9.
Acanfora D, Trojano L, Iannuzzi GL, et al. The brain in congestive heart failure. Arch Gerontol Geriatr. 1996;23(3):247–256.
10.
Tomita S, Li RK, Weisel RD, et al. Autologous transplantation of bone marrow cells improves damaged heart function. Circulation. 1999;100(Suppl 19):II247–II256.
11.
Lainchbury JG, Troughton RW, Frampton CM, et al. NTproBNP-guided drug treatment for chronic heart failure: design and methods in the “BATTLESCARRED” trial. Eur J Heart Fail. 2006;8(5):532–538.
12.
Trojano L, Antonelli Incalzi R, Acanfora D, et al; Congestive Heart Failure Italian Study Investigators. Cognitive impairment: a key feature of congestive heart failure in the elderly. J Neurol. 2003;250(1):1456–1463.
13.
Strauer BE, Brehm M, Zeus T, et al. Repair of infarcted myocardium by autologous intracoronary mononuclear bone marrow cell transplantation in humans. Circulation. 2002;106(15):1913–1918.
14.
Tomita S, Mickle DA, Weisel RD, et al. Improved heart function with myogenesis and angiogenesis after autologous porcine bone marrow stromal cell transplantation. J Thorac Cardiovasc Surg. 2002;123(6):1132–1140.
15.
Jefferson AL, Benjamin EJ. Cardiovascular disease, cognitive decline, and dementia. In: Wahlund LO, Erkinjuntti T, Gauthier S, editors. Vascular Cognitive Impairment in Clinical Practice. Cambridge, UK: Cambridge University Press; 2009:166–177.
DOI
16.
Ohno N, Fedak PW, Weisel RD, Komeda M, Mickle DA, Li RK. Cell transplantation in non-ischemic dilated cardiomyopathy. A novel biological approach for ventricular restoration. Jpn J Thorac Cardiovasc Surg. 2002;50(11):457–460.
17.
Feigenbaum H, editor. Echocardiography. 5th ed. Philadelphia, PA: Lea and Febiger; 1994.
18.
Kamihata H, Matsubara H, Nishiue T, et al. Implantation of bone marrow mononuclear cells into ischemic myocardium enhances collateral perfusion and regional function via side supply of angioblasts, angiogenic ligands, and cytokines. Circulation. 2001;104(9):1046–1052.
19.
Taupin P. Stem Cells and Regenerative Medicine: Volume III: Pharmacology and Therapy. New York, NY: Nova Science Publishers; 2008.
20.
Pittenger MF, Mackay AM, Beck SC, et al. Multilineage potential of adult human mesenchymal stem cells. Science. 1999;284(5411):143–147.
21.
Makino S, Fukuda K, Miyoshi S, et al. Cardiomyocytes can be generated from marrow stromal cells in vitro. J Clin Invest. 1999;103(5):697–705.
22.
Wang JS, Shum-Tim D, Galipeau J, Chedrawy E, Eliopoulos N, Chiu RC. Marrow stromal cells for cellular cardiomyoplasty: Feasibility and potential clinical advantages. J Thorac Cardiovasc Surg. 2000;120(5):999–1006.
23.
Vogels RL, Oosterman JM, van Harten B, et al. Neuroimaging and correlates of cognitive function among patients with heart failure. Dement Geriatr Cogn Disord. 2007;24(6):418–423.
24.
Cacciatore F, Abete P, Ferrara N, et al. Congestive heart failure and cognitive impairment in an older population. Osservatorio Geriatrico Campano Study Group. J Am Geriatr Soc. 1998;46(11):1343–1348.
25.
Sakakibara Y, Tambara K, Lu F, et al. Combined procedure of surgical repair and cell transplantation for left ventricular aneurysm: an experimental study. Circulation. 2002;106(12 Suppl 1):I193–I197.
26.
Shumakov VI, Onischenko NA, Krasheninnikov ME, et al. The stromal bone marrow stem cells differentiation into cardiomyocyte cells in various mammalian species. Bulletin of Experimental Biology and Medicine. 2003;4:461–465.
27.
Le Blanc K, Ringdén O. Immunobiology of human mesenchymal stem cells and future use in hematopoietic stem cell transplantation. Biol Blood Marrow Transplant. 2005;11(5):321–334.
28.
Evans MJ, Kaufman MH. Establishment in culture of pluripotential cells from mouse embryos. Nature. 1981;292(5819):154–156.
29.
Panteghini M. Recommendations on use of biochemical markers in acute coronary syndrome: IFCC proposals. eJIFCC, no 14, 2004. Available from: http://www.ifcc.org/ifcc-communications-publications-division-%28cpd%29/ifcc-publications/ejifcc-%28journal%29/e-journal-volumes/vol-14-n%C2%B0-2/recommendations-on-use-of-biochemical-markers-in-acute-coronary-syndrome-ifcc-proposals/. Accessed July 17, 2014.
30.
Anderson A, Nielsen JM, Peters CD, Schou UK, Sloth E, Nielsen-Kudsk JE. Effects of phosphodiesterase-5 inhibition by sildenafil in the pressure overloaded right heart. Eur J Heart Fail. 2008;10(2):1158–1165.
31.
Georgiadis D, Sievert M, Cencetti S, et al. Cerebrovascular reactivity is impaired in patients with cardiac failure. Eur Heart J. 2000;21(5):407–413.
32.
Menasché P, Hagège AA, Scorsin M, et al. Myoblast transplantation for heart failure. Lancet. 2001;357(9252):279–280.
33.
Nichols WW, O’Rourke MF. Aging, high blood pressure and disease in humans. In: Nichols WW, O’Rourke MF, editors. McDonald’s Blood Flow in Arteries: Theoretical, Experimental and Clinical Principles. 3rd ed. London, UK: Edward Arnold; 1990:398–420.
34.
Orlic D, Kajstura J, Chimenti S, et al. Bone marrow cells regenerate infarcted myocardium. Nature. 2001;410(6829):701–705.
Publication history
Copyright
Rights and permissions

Publication history

Published: 30 August 2014
Issue date: December 2014

Copyright

© 2014 The Author(s).

Rights and permissions

© 2014 Klunnyk et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License. The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at: http://www.dovepress.com/permissions.php

Return