720 Dilated cardiomyopathy: labelled stem cells transplantation with 99m-Tc HMPAO to the myocardium

Purpose: To characterize the early term results of CRT combined: SCT in patients under optimized pharmacological therapy, with HF (NYHA Class III and IV), and intraventricular dysynchronization, Ejection Fraction (EF) <35%, and without severe mitral regurgitation. Method: Patients with CRT indication were submitted to SCT at the time of device implantation or after no more than a week. The Iliac posterior crests were punctioned under peridural anesthesia to obtain 40 or 50 ml of bone marrow cells. The blood was filtered and speared by centrifugation in Ficoll, more than 1 to 2 x 108 mononuclear cells were obtained. The left ventricle stimulation was achieved with an epicardial lead (left minitoracotomy), under the same approach were injected with 0,2 cc of mononuclear cells in each puncture (total 10 ml, directly in ventricle muscle, in all epicardial faces). The control parameters are EF, wall motion, collateral vessels growing, clinical status, BNP level, performed by echocardiography, (Simpson Method) Nuclear Medicine (MIBG, Gated and Scintilography), Coronaryarteriography, clinical review. Results: Since April 2005, 10 patients received CRT and SCT epicardial implantation. The mean age was 65,8 years (49 to 77). The etiology of the dilated cardiomyopathy were, in 2 pts Idiopathic (IDC), in 3 pts Ischemic(IC) and 5 pts Chagas disease(CDC).Three pts. With A-V block and 7 with LBBB. The mean pre-op EF was 19% and in 4 pts with more than 6 months follow-up, were 31%, measured by Simpson method. The mean BNP level pre op was 430 pg/mL, and changed for normal levels. After 10 months follow up all patients increased quality of life and exercise capacity. The cintilography studies made in 3 pts that had more than 6 months of follow-up, showed the differentiation of the two therapies. There was no hospital mortality. Conclusions: CRT and SCT seem to be a good alternative to treat HF. Both procedures made at the same time are safe and feasible.