Long-term results after intracoronary injection of autologous mononuclear bone marrow cells in acute myocardial infarction: the ASTAMI randomised, controlled study

Beitnes, Jan Otto; Hopp, Einar; Lunde, Ketil; Solheim, Svein; Arnesen, Harald; Brinchmann, Jan E.; Forfang, Kolbjørn; Aakhus, Svend

doi:10.1136/hrt.2009.178913

Cited by 146 publications

(73 citation statements)

References 32 publications

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“…Based on meta-regression analyses, these interventions have had positive outcomes, documenting the feasibility and safety of this therapeutic strategy and, in most cases, the beneficial effects on cardiac function. An average significant increase in ejection fraction of 3 percentage points has been reported (83, 84), although studies have also been published that indicate no changes in ejection fraction (92)(93)(94)(95)(96). Although enroll- ment is ongoing for a large clinical trial to test the effect on mortality of the delivery of mononuclear bone marrow cells (BAMI; http:// www.euram.ltd.uk/BAMI/), the documentation of tissue-specific adult CSCs offers an alternative and theoretically more effective form of cell therapy for patients with chronic heart failure (CHF).…”

Section: Future Directionsmentioning

confidence: 99%

Regenerating new heart with stem cells

Anversa

Kajstura²,

Rota³

et al. 2013

J. Clin. Invest.

144

126

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This article discusses current understanding of myocardial biology, emphasizing the regeneration potential of the adult human heart and the mechanisms involved. In the last decade, a novel conceptual view has emerged. The heart is no longer considered a postmitotic organ, but is viewed as a self-renewing organ characterized by a resident stem cell compartment responsible for tissue homeostasis and cardiac repair following injury. Additionally, HSCs possess the ability to transdifferentiate and acquire the cardiomyocyte, vascular endothelial, and smooth muscle cell lineages. Both cardiac and hematopoietic stem cells may be used therapeutically in an attempt to reverse the devastating consequences of chronic heart failure of ischemic and nonischemic origin. IntroductionOur understanding of the process of myocardial regeneration is currently under debate. Although the adult human heart is no longer considered a static organ unable to replace its parenchymal cells during the course of life, the rate of myocyte regeneration reported thus far varies dramatically. Minimal levels of myocyte turnover, which decrease with age, have been claimed (1-5), but results have also been obtained supporting continuous myocyte renewal at a remarkable degree (6-12). Independent from the extent of the process, the debate is further intensified by contrasting views regarding the origin of newly formed cardiomyocytes (13,14). These issues have important implications because knowledge of the magnitude of cell regeneration and the mechanisms involved may offer a novel dynamic perspective of cardiac homeostasis and myocardial biology. This information is critical for the identification of strategies aiming at the restoration of the functional and structural integrity of the failing human heart.The recognition that the adult heart harbors a compartment of multipotent c-kit-positive cardiac stem cells (CSCs) (15-23) and other progenitor cell classes (24-29) capable of differentiating into cardiomyocytes and coronary vessels has raised the challenging question concerning their embryologic origin and role in cardiac cell turnover and regeneration. CSCs are stored in interstitial structures with the characteristics of stem cell niches and can divide symmetrically and asymmetrically, with the ability to self-renew and form a committed progeny (17,21,30). But whether this stem cell pool is actually self-autonomous and fully distinct from HSCs in the bone marrow remains to be determined. c-kit-positive HSCs transdifferentiate and acquire the myocyte, endothelial cell, and smooth muscle cell lineage (31), suggesting that the bone marrow participates in the homeostatic control of the myocardium and the restoration of myocytes and coronary vessels following injury. Additionally, the possibility has been advanced that postmitotic myocytes dedifferentiate, acquire an immature cell phenotype, and then reenter the cell cycle and divide (32-35), representing an alternative or complementary modality of myocyte formation. In this Review, we discuss CSCs, HS...

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Section: Future Directionsmentioning

confidence: 99%

Regenerating new heart with stem cells

Anversa

Kajstura²,

Rota³

et al. 2013

J. Clin. Invest.

144

126

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show abstract

“…The end points in these studies were a change in left ventricular ejection fraction (LVEF) or combined end points of myocardial infarction or readmission. By contrast, the Autologous Stem cell Transplantation in Acute Myocardial Infarction (ASTAMI) 5 and the Bone Marrow transfer to Enhance ST-elevation Infarct Regeneration (BOOST) 6 trials failed to show long-term benefits of autologous BMC therapy. Although the reasons for the differences in long-term outcomes of BMC-treated patients with ischemic heart disease remain largely unclear, they may be partially explained by the different degrees of functional exhaustion of BMCs in patients after myocardial infarction.…”

mentioning

confidence: 99%

Effects of Intracoronary CD34 ⁺ Stem Cell Transplantation in Nonischemic Dilated Cardiomyopathy Patients

Vrtovec¹,

Poglajen²,

Ležaič

et al. 2013

Circulation Research

256

220

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“…Although the number of patients in the trial by Losordo et al is fairly small, only a handful of similarly sized trials have been published. [2][3][4] In the recent past, the merit of performing clinical trials of cardiac cell therapy was debated in the literature. 5,6 However, the study of regenerative cardiac medicine continues to move forward, despite the fact that opponents have highlighted the many challenges in the field, focusing mainly on the lack of mechanistic data.…”

Section: T He Article By Losordo Et Al 1 In This Issue Of Circulationmentioning

confidence: 99%

CD34 ⁺ Autologous Human Stem Cells in Treating Refractory Angina

Perin¹,

Willerson²

2011

Circulation Research

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Long-term results after intracoronary injection of autologous mononuclear bone marrow cells in acute myocardial infarction: the ASTAMI randomised, controlled study

Abstract: The results indicate that intracoronary mBMC treatment in AMI is safe in the long term. A small improvement in exercise time in the mBMC group was found, but no other effects of treatment could be identified 3 years after cell therapy.

Cited by 146 publications

References 32 publications

Regenerating new heart with stem cells

Regenerating new heart with stem cells

Effects of Intracoronary CD34 ⁺ Stem Cell Transplantation in Nonischemic Dilated Cardiomyopathy Patients

CD34 ⁺ Autologous Human Stem Cells in Treating Refractory Angina

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Long-term results after intracoronary injection of autologous mononuclear bone marrow cells in acute myocardial infarction: the ASTAMI randomised, controlled study

Abstract: The results indicate that intracoronary mBMC treatment in AMI is safe in the long term. A small improvement in exercise time in the mBMC group was found, but no other effects of treatment could be identified 3 years after cell therapy.

Cited by 146 publications

References 32 publications

Regenerating new heart with stem cells

Regenerating new heart with stem cells

Effects of Intracoronary CD34 + Stem Cell Transplantation in Nonischemic Dilated Cardiomyopathy Patients

CD34 + Autologous Human Stem Cells in Treating Refractory Angina

Contact Info

Product

Resources

About

Effects of Intracoronary CD34 ⁺ Stem Cell Transplantation in Nonischemic Dilated Cardiomyopathy Patients

CD34 ⁺ Autologous Human Stem Cells in Treating Refractory Angina