The autologous bone marrow mononuclear cell transplantation by intracoronary route treat patients with severe heart failure after myocardial infarction.
- Author:
Lian-ru GAO
1
;
Chao-shu TANG
;
Zhi-ming ZHU
;
Zhi-guo WANG
;
Yu-xing FEI
;
Hai-tao TIAN
;
Jia-rui ZHU
;
Sheng HE
;
Qing-ai DING
;
Ye YANG
Author Information
- Publication Type:Journal Article
- MeSH: Bone Marrow Transplantation; Coronary Vessels; surgery; Follow-Up Studies; Heart Failure; complications; Humans; Mesenchymal Stem Cell Transplantation; Monocytes; transplantation; Myocardial Infarction; surgery; Myocardial Ischemia; complications; Transplantation, Autologous
- From: Chinese Journal of Cardiology 2006;34(7):582-586
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo investigate the chronic effects of intracoronary autologous bone marrow mononuclear cell (BM-MNCs) transplantation in patients with refractory heart failure (RIHF) after myocardial infarction.
METHODSThirty patients with RIHF (LVEF < 40%) were enrolled in this nonrandomized study, autologous BM-MNCs (5.0 +/- 0.7) x 10(7) were transplanted with via infarct-related coronary artery in 16 patients and 14 patients received standard medical therapy served as control. Baseline and follow up evaluations included complete clinical evaluations, plasma BNP, ANP, ET-1 measurements, echocardiography, PET, and Holter monitoring.
RESULTSBaseline characteristics were similar between the 2 groups. There were no major periprocedural complications. One patient developed ventricular premature contractions during cell infusion for several seconds and recovered spontaneously. Compared to pre-transplantation, plasma BNP and ET-1 significantly decreased and plasma ANP significantly increased at 7 days post transplantation; 6 minutes walking distance increased from (72.1 +/- 31.5) to (201.6 +/- 23.3) m (P < 0.01), LVEF increased 9.9% (P < 0.001) and FDG-PET revealed vital myocardium area increased (10.3 +/- 3.4)% (P < 0.01) at 3 months after BM-MNCs transplantation. At 6 months follow up, the NYHA class improved from (3.4 +/- 0.1 to 2.4 +/- 0.2, P < 0.001) and no patient died and 1 patient rehospitalized due to lower extremities edema. In control group, LVEF decreased 7.2% compared to baseline (P < 0.001) and was significantly lower than transplantation group at 3 months (P < 0.001). At 6 months follow up, the NYHA class increased from (3.5 +/- 0.1 to 3.9 +/- 0.1, P < 0.05), 2 patients died and 10 patients rehospitalized due to aggravated heart failure.
CONCLUSIONPresent study demonstrates that intracoronary transplantation of autologous BM-MNCs is safe and effective for treating patients with RIHF after myocardial infarction.