Revista Colombiana de Cardiología
versão impressa ISSN 0120-5633
ORREGO, Carlos M et al. Heart rate variability and cardiac rhythm alterations associated with stem cell therapy in cardiovascular disease. Rev. Col. Cardiol. [online]. 2007, vol.14, n.6, pp. 353-358. ISSN 0120-5633.
Introduction: in patients with chronic heart failure and ischemic cardiopathy eligible for therapy with stem cells derived from bone marrow, it has been demonstrated that there is a decrease in Heart Rate Variability (HRV), measured by the standard deviation of RR interval (NN) SDNN, situation related to an increase of cardiovascular risk and arrhythmic events as direct consequence of autonomous nervous system dysfunction. Methods: patients that received autologous transplant derived from bone marrow and that had acute or chronic ischemic heart disease with ejection fraction less than 45% susceptible or not of surgical revascularization and with zones of necrotic and viable myocardial tissue, were analyzed. 24 hours Holter monitoring before transplant and at two, six and twelve months after the intervention was performed. Results: data of 16 patients regarding maximal, minimal and mean heart rate average, variability of heart rate and appearance of malign ventricular arrhythmias were analyzed. Therapy with stem cells derived from bone marrow was associated with a statistically significant improvement of heart rate variability (SDNN) going from 65.44 ± 27 ms. to 102.12 ± 37.88 ms. (p=0.004) and 100.23 ± 42.88 ms. (p=0.013) at 2 and 6 months respectively. With regard to the cardiovascular risk classification according to the variability of heart rate (SDNN), all patients considered at high risk (SDNN <50ms.) before the procedure, turned to intermediate or low risk in the six months follow-up. Besides, no greater risk of developing malign ventricular arrhythmias was found during the follow-up after therapy with stem cells derived from bone marrow. Conclusion: in patients with ischemic cardiopathy under autologous bone marrow transplant for myocardial regeneration, variability of heart rate measured by SDNN increases significantly, carrying with it a decrease in cardiovascular risk. Furthermore, risk of increased ventricular arrhythmias was not found.
Palavras-chave : heart rate variability (SDNN); ventricular arrhythmias; autologous transplant derived from bone marrow; ischemic cardiopathy.