Intracoronary Bone Marrow–Derived Progenitor Cells in Acute Myocardial Infarction

Abstract

Intracoronary administration of BMC is associated with improved recovery of left ventricular contractile function in patients with acute myocardial infarction. Large-scale studies are warranted to examine the potential effects of progenitor-cell administration on morbidity and mortality.

Adult bone marrow–derived stem cells for organ regeneration and repair

“…Two trials did not show an improvement of cardiac function in patients treated with autologous bone marrow (Lunde et al, 2005;Janssens et al, 2006), and the BOOST trial documented an improvement in LVEF after 6 months but no difference after 18 months. In contrast, the REPAIR-AMI trial showed a significant improvement in the treatment group after 4 months and all endpoints were still significantly better one year after treatment (Schachinger et al, 2006a). Perhaps the most significant finding in this trial was the fact that patients with the worst ejection fraction before treatment benefited the most, and that a longer time span between infarction and treatment resulted in a better outcome.…”

Stem Cells Improve Left Ventricular Function in Acute Myocardial Infarction

“…In the trial by Lunde et al, 6 LV dysfunction was defined as 3 or more hypokinetic left ventricle segments observed on echocardiography. In the study by Schächinger et al, 5 LV dysfunction was defined as substantial residual left ventricular regional wall motion abnormality (as defined by an ejection fraction ≤45% according to a visual estimate). Janssens et al 8 defined LV dysfunction as hypokinesia or akinesia, involving more than half of the anterior, septal, or inferior wall, using angiography, or involving 3 contiguous segments or more out of 17, using echocardiography.…”

“…Our search yielded 7 randomized controlled trials (Suárez de Lezo et al, 4 Schächinger et al, 5 Lunde et al, 6 Ge et al, 7 Janssens et al, 8 Wollert et al, 9 and Chen et al 10 ), evaluating changes in LVEF following intracoronary BMC therapy in relation to control groups. A meta-analysis of 516 patients (BMC group, 256; control group, 260) was performed (Table 1 and 2).…”

Thérapies cellulaires pro-angiogéniques dans le traitement des pathologies ischémiques

“…Cependant, un certain nombre de ces patients présentent des effets secondaires, et l'amélio-ration n'est souvent que transitoire [27]. De même, la transplantation par voie intracoronaire de cellules mononucléées médullaires dans le myocarde de patients ayant une ischémie aiguë augmente la perfusion et la fonction du tissu ischémié [28][29][30]. Dans cette indication égale-ment, certaines études montrent le caractère transitoire de l'amélio-ration, d'autres une absence d'effet, soulignant ainsi la nécessité de poursuivre l'analyse à la fois expérimentale et clinique de l'efficacité thérapeutique de ces stratégies [31,32].…”