Intracoronary Injection of Autologous Bone Marrow-Derived Mononuclear Cells in Patients With Large Anterior Acute Myocardial Infarction

Pěnička, Martin; Horák, Jan; Kobylka, Petr; Pytlik, Robert; Kozák, Tomáš; Bělohlávek, Otakar; Lang, Otto; Skalická, Hana; Šimek, Stanislav; Paleček, Tomáš; Linhart, Aleš; Aschermann, Michael; Widimský, Petr

doi:10.1016/j.jacc.2007.04.009

Cited by 83 publications

(42 citation statements)

References 7 publications

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“…Of these, 622 were nonrandomized studies, editorials, or reviews, and 83 of these were examined in more detail. Seventeen of the 83 references were eligible for inclusion [2][3][4][5][6][7][19][20][21][22][23][24][25][26][27][28][29] (Figure 1). …”

Section: Search Resultsmentioning

confidence: 99%

The effect of rigorous study design in the research of autologous bone marrow-derived mononuclear cell transfer in patients with acute myocardial infarction

et al. 2013

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Introduction: Although blinding is a methodologic safeguard to ensure obtaining comparability of groups in a clinical trial, it is very difficult to maintain blinding from the beginning to the end of a study. The aim of the study was to see how proper blinding of both participants and treatment providers from the planning phase of the study to during the study affected the study outcomes. Methods: We searched Medline, EMBASE, and Cochrane databases from inception to November 2011. The studies included in this review were randomized controlled trials, with acute myocardial infarction (AMI) patients who received percutaneous coronary intervention (PCI), intracoronary (IC) infusion of autologous bone marrow stem cells (BMSCs), unselected BMSCs, 10 8 or more cell dose, and up to 6-month follow-up periods.

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Section: Search Resultsmentioning

confidence: 99%

The effect of rigorous study design in the research of autologous bone marrow-derived mononuclear cell transfer in patients with acute myocardial infarction

et al. 2013

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“…The last decade has seen the start of many clinical trials to assess the effect of intracoronary injection of stem cells on cardiac repair after AMI (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17). Nevertheless, the results obtained are still equivocal and suggest that differ- ences in the type and number of cells injected, administration mode, and follow-up time may hamper a proper assessment of the efficacy of this novel treatment (17,27,28).…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, the results obtained are still equivocal and suggest that differ- ences in the type and number of cells injected, administration mode, and follow-up time may hamper a proper assessment of the efficacy of this novel treatment (17,27,28). Different imaging techniques have been used to assess the changes in cardiac function (3,4,(6)(7)(8)11,(13)(14)(15)17) and myocardial perfusion after stem cell transplantation (5,(8)(9)(10)(11). However, besides the evaluation of cardiac function obtained in all studies by means of LVEF estimation along with the measurement of other kinetic parameters, changes in myocardial flow have been assessed mostly with an automated quantification of infarct size calculated from MRI (7,8,14), perfusion scintigraphy (2,5,6,10,17), and 18 F-FDG PET images (29) or with a visual analysis of 99m Tc-sestamibi uptake in necrotic segments (16,30,31).…”

Section: Discussionmentioning

confidence: 99%

“…The use of stem cells with angiogenic properties for therapy of myocardial infarction has been widely investigated, and several clinical studies have demonstrated the feasibility of intracoronary injection of various cell preparations derived from bone marrow and peripheral blood (2)(3)(4)(5)(6)(7)(8). Nevertheless, the efficacy of this novel treatment is still under investigation, it being unclear whether patients who have undergone stem cell therapy have a greater improvement in left ventricular function (LVEF) and a greater reduction of infarct size than do patients treated with standard therapy for AMI (3,4,(9)(10)(11)(12)(13)(14)(15)(16)(17). Besides the different imaging methods used for the estimation of LVEF and infarct size, a quantitative evaluation of myocardial blood flow (MBF) in scarred and non-infarct-related areas has been attempted only with 11 C-acetate PET (8).…”

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confidence: 99%

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The Role of PET with ¹³N-Ammonia and ¹⁸F-FDG in the Assessment of Myocardial Perfusion and Metabolism in Patients with Recent AMI and Intracoronary Stem Cell Injection

et al. 2010

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Over the last decade, the effects of stem cell therapy on cardiac repair after acute myocardial infarction (AMI) have been investigated with different imaging techniques. We evaluated a new imaging approach using 13 N-ammonia and 18 F-FDG PET for a combined analysis of cardiac perfusion, metabolism, and function in patients treated with intracoronary injection of endothelial progenitors or with conventional therapy for AMI. Methods: A total of 15 patients were randomly assigned to 3 groups based on different treatments (group A: bone marrow-derived stem cells; group B: peripheral blood-derived stem cells; group C: standard therapy alone). The number of scarred and viable segments, along with the infarct size and the extent of the viable area, were determined on a 9-segment 13 N-ammonia/ 18 F-FDG PET polar map. Myocardial blood flow (MBF) was calculated for each segment on the ammonia polar map, whereas a global evaluation of left ventricular function was obtained by estimating left ventricular ejection fraction (LVEF) and end-diastolic volume, both derived from electrocardiography-gated 18 F-FDG images. Both intragroup and intergroup comparative analyses of the mean values of each parameter were performed at baseline and 3, 6, and 12 mo after AMI. During follow-up, major cardiac events were also registered. Results: A significant decrease (P , 0.05) in the number of scarred segments and infarct size was observed in group A, along with an increase in MBF (P , 0.05) and a mild improvement in cardiac function. Lack of infarct size shrinkage in group B was associated with a marked impairment of MBF (P 5 0.01) and cardiac dysfunction. Ambiguous changes in infarct size, MBF, and LVEF were found in group C. No differences in number of viable segments or in extent of viable area were found among the groups. At clinical follow-up, no major cardiac events occurred in group A patients, whereas 2 patients of group B experienced in-stent occlusion and one patient of group C received a transplant for heart failure. Conclusion: Our data suggest that a single nuclear imaging technique accurately analyzes changes in myocardial perfusion and metabolism occurring after stem cell transplantation.

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“…cardiac function. [4][5][6][7] This indicates that factors such as cell type, number of transplanted cells, optimal timing, cell delivery route, and the mechanism of action remain to be explored.…”

Section: Introductionmentioning

confidence: 99%

Dual-modal tracking of transplanted mesenchymal stem cells after myocardial infarction

Li¹,

Yao²,

Sheng³

et al. 2011

IJN

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Purpose: Results for implantation efficiency and effective improvement of cardiac function in the field of mesenchymal stem cells (MSCs) are controversial. To attempt to clarify this debate, we utilized magnetic resonance imaging (MRI) and near-infrared optical imaging (OI) to explore the effects of different delivery modes of mesenchymal stem cells on cell retention time and cardiac function after myocardial infarction (MI). Methods: Rat MSCs were labeled with superparamagnetic iron oxide nanoparticles and 1, 1′-dioctadecyl-3,3,3′,3′-tetramethylindodicarbocyanine, 4-chlorobenzenesulfonate salt (DiD) for noninvasive cell tracking in a rat MI model. Rats underwent coronary artery ligation and were randomized into three experimental groups: intravenous (IV), intramyocardial (IM), and a control group. The first two groups referred to the route of delivery of the transplanted dual-labeled MSCs; whereas the control group was given an IV injection of serum-free medium one day post-MI. Cellular engraftment was determined 1 day and 7 days post cell delivery by measuring the iron and optical signals in explanted organs. Prussian blue staining and fluorescent microscopy were performed on histological sections for iron and DiD, respectively. Cardiac function was measured by echocardiography on day 7. Results: The cardiac function of the IM group increased significantly compared to the IV and control groups at day 7. In the IM group, labeled cells were visualized in the infracted heart by serial MRI, and the intensity by OI was significantly higher on day 1. In the IV group, the heart signals were significantly attenuated by dual-modal tracking at two time points, but the lung signals in OI were significantly stronger than the IM group at both time points. Conclusion: IM injection of MSCs increased cell engraftment within infarcted hearts and improved cardiac function after MI. However, IV infusion has a low efficacy due to the cell trapping in the lung. Therefore, direct injection may provide an advantage over IV, with regard to retention of stem cells and protection of cardiac function.

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Intracoronary Injection of Autologous Bone Marrow-Derived Mononuclear Cells in Patients With Large Anterior Acute Myocardial Infarction

Cited by 83 publications

References 7 publications

The effect of rigorous study design in the research of autologous bone marrow-derived mononuclear cell transfer in patients with acute myocardial infarction

The effect of rigorous study design in the research of autologous bone marrow-derived mononuclear cell transfer in patients with acute myocardial infarction

The Role of PET with ¹³N-Ammonia and ¹⁸F-FDG in the Assessment of Myocardial Perfusion and Metabolism in Patients with Recent AMI and Intracoronary Stem Cell Injection

Dual-modal tracking of transplanted mesenchymal stem cells after myocardial infarction

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Intracoronary Injection of Autologous Bone Marrow-Derived Mononuclear Cells in Patients With Large Anterior Acute Myocardial Infarction

Cited by 83 publications

References 7 publications

The effect of rigorous study design in the research of autologous bone marrow-derived mononuclear cell transfer in patients with acute myocardial infarction

The effect of rigorous study design in the research of autologous bone marrow-derived mononuclear cell transfer in patients with acute myocardial infarction

The Role of PET with 13N-Ammonia and 18F-FDG in the Assessment of Myocardial Perfusion and Metabolism in Patients with Recent AMI and Intracoronary Stem Cell Injection

Dual-modal tracking of transplanted mesenchymal stem cells after myocardial infarction

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The Role of PET with ¹³N-Ammonia and ¹⁸F-FDG in the Assessment of Myocardial Perfusion and Metabolism in Patients with Recent AMI and Intracoronary Stem Cell Injection