[Full Reverse Left Ventricle Conteractility Function Remodeling and Recovery in Patient With Dilated Cardiomyopathy. Clinical Case].

The article presents a clinical case of a patient with severe chronic heart failure of ischemic origin. In 2020, the patient with a long history of ischemic heart disease, as confirmed by clinical data and instrumental examination, was diagnosed with severe cardiomegaly and NYHA class III chronic heart failure. The course of heart failure was aggravated by the presence of arrhythmia in the form of atrial fibrillation. At the first stage, a drug therapy and lifestyle modifications were recommended. In 2021, a beneficial tendency in clinical and instrumental indexes was observed, which made it possible to move on to the surgical stage of treatment. A coronary artery bypass grafting was performed with ablation of the left atrial posterior wall using the "box lesion" technique. A follow-up examination performed a year later showed normalization of the left ventricular dimension and recovery of its contractile function. The symptoms of heart failure regressed to the level of NYHA functional class I; no relapses of atrial fibrillation were detected. The patient continues to receive recommended drug therapy.

[Cell therapy in the multimodality treatment of a patient with dilated cardiomyopathy. A case report].

We present a 13-years follow-up results in patient with dilated cardiomyopathy. We performed intracoronary infusion of bone marrow mononuclear fraction in patient with 4th heart failure functional class in 2005. We observed an improvement in symptoms (patient had 1st functional class of heart failure) during 10-years follow-up. In 2015 due to clinical worsening we performed 2nd and 3rd bone marrow mononuclear cells infusion with 9-month interval. We observed a signifcant improvement in symptoms, EF and LV sizes. We continue the follow-up.

[Long-term results of clinical application of autologous mononuclear bone marrow fraction for regeneration therapy of ischemic heart disease patients].

An experience with using autologous bone marrow mononuclears for regeneration of the heart was analyzed in 97 patients in whom the intracoronary transplantation of autologous mononuclear bone marrow cells was performed. The results were estimated in terms up to 5 years and compared with a group of 37 patients who underwent only conservative treatment. A distinct positive dynamic of clinical and echocardiographic indices in the main group was noted in a subgroup of patients with a decreased ejection fraction (EF less than 50%) as compared with an analogous subgroup of patients in the control group. Substantial influence is exerted by regeneration therapy upon remote lethality. Thus, as a whole in the main group lethality over 5 years was 13.4% and in the group of control it was 21.6%. In the subgroup with a decreased ejection fraction and symptoms of heart failure lethality was 22.6% in the main group and 54.5%--in the control group. The intracoronary administration of the autologous bone marrow mononuclear fraction to inoperable patients with ischemic heart disease and a severe lesion of the coronary arteries and a decreased ejection fraction of the left ventricle is a safe and useful procedure resulting to substantially decreased lethality followed-up during 5 years against the background of conservative treatment.

[Quality of life in patients with coronary artery disease after stem cell therapy].

The main group included 17 patients with distal lesion of the coronary bed in whom the performance of complete direct myocardium revascularization was not possible. The autologous bone marrow mononuclears were administered to the main group patients at the period from 2008 to 2010. The control group consisted of 10 patients given standard medicamentous therapy. A year later in the main group patients there was a decrease of median of the functional stenocardia class, median of metabolic units by the data of loading tests, median of the number of nitroglycerin pills for a week taken by the patients as compared with the control group. By the data of OECT and PECT a year later in the main group there was an improved perfusion in all the myocardium segments. In the control group on the contrary there was negative dynamics in all the indices in question.

[Ejection fraction and sizes of the left ventricle of the heart after intracoronary administration of autologous mononuclear cells of the bone marrow in patients with coronary artery disease with low ejection fraction].

Since 2003 intracoronary administration of autologous bone marrow mononuclear cells has been performed in 119 patients with inoperable coronary artery disease, 53 of which had reduced ejection function that was gradually increased after injection of mononuclear bone marrow cells. By the 6th year the difference between the median of systolic and diastolic sizes of the left ventricle decreased by 12 and 14 mm respectively. In the control group the dynamics of changes of these indices at the same period was of negative character. The introduction of intracoronary bone marrow mononuclear cells is a safe and effective method of invasive therapy in patients with coronary artery disease to whom surgery is contraindicated.