Intracoronary Bone Marrow Cell Transfer After Myocardial Infarction

Abstract

Background-Intracoronary transfer of autologous bone marrow cells (BMCs) may enhance recovery of left ventricular (LV) function in patients after acute myocardial infarction (AMI). However, clinical studies addressing the effects of BMCs after AMI have covered only limited time frames ranging from 3 to 6 months. The critical question of whether BMC transfer can have a sustained impact on LV function remains unanswered. Methods and Results-After percutaneous coronary intervention with stent implantation (PCI) of the infarct-related artery, 60 patients were randomized 1:1 to a control group with optimal postinfarction therapy and a BMC transfer group that also received an intracoronary BMC infusion 4.8Ϯ1.3 days after PCI. Cardiac MRI was performed 3.5Ϯ1.5 days, 6Ϯ1 months, and 18Ϯ6 months after PCI. BMC transfer was not associated with adverse clinical events. In the control group, mean global LV ejection fraction increased by 0.7 and 3.1 percentage points after 6 and 18 months, respectively. LV ejection fraction in the BMC transfer group increased by 6.7 and 5.9 percentage points. The difference in LVEF improvement between groups was significant after 6 months but not after 18 months (Pϭ0.27). The speed of LV ejection fraction recovery over the course of 18 months was significantly higher in the BMC transfer group (Pϭ0.001). Conclusions-In this study, a single dose of intracoronary BMCs did not provide long-term benefit on LV systolic function after AMI compared with a randomized control group; however, the study suggests an acceleration of LV ejection fraction recovery after AMI by BMC therapy. (Circulation. 2006;113:1287-1294.)

Conditional Transgenic Expression of Fibroblast Growth Factor 9 in the Adult Mouse Heart Reduces Heart Failure Mortality After Myocardial Infarction

“…We have previously shown that intracoronary infusion of autologous BMCs enhances the recovery of systolic function in postinfarct patients, 13,44 and we have identified FGF9 as a factor that is secreted from these cells. 14 Given the results of the present study, FGF9-mediated paracrine effects in the border zone of the infarct may contribute to the improvements in microvascular perfusion and regional contractility that have been observed after intracoronary BMC transfer in some clinical trials.…”

Attenuation of Autoimmune Myocarditis in Rats by Mesenchymal Stem Cell Transplantation Through Enhanced Expression of Hepatocyte Growth Factor

“…21) However, recent studies have provided conflicting results. [22][23][24] In addition, there have been few reports concerning the therapeutic potential of MSC transplantation for nonischemic heart disease.…”

Protective paracrine effect of mesenchymal stem cells on cardiomyocytes

“…Bone marrow-derived mesenchymal stem cells (MSCs) are considered effective in myocardial infarction therapies both in basic research studies (Amado et al, 2005;Tang et al, 2006) and in clinical trials (Janssens et al, 2006;Meyer et al, 2006). MSCs repair the ischemic myocardium primarily by angioblast-mediated vasculogenesis (Kocher et al, 2001), prevention of apoptosis of native cardiomyocytes, or by direct regeneration of the lost cardiomyocytes (Shim et al, 2004;Takahashi et al, 2006).…”