Russian Heart Failure Journal 2010year Efficacy and safety of intracoronary transplantation of bone marrow mononuclear cells in patients with postinfarction myocardial changes and heart failure


To access this material please log in or register

Register Authorize
2010/

Efficacy and safety of intracoronary transplantation of bone marrow mononuclear cells in patients with postinfarction myocardial changes and heart failure

Bazhan S.S., Sychev A.V., Mareev V.Y., Samko A.N., Stukalova O.V., Saidova M.A., Shitov V.N., Sergienko V.B., Romanov Y.A., Sokolov A.N., Belenkov Y.N.

Keywords: intracoronary transplantation, bone marrow mononuclear cells, postinfarction cardiosclerosis, chronic heart failure

DOI: 10.18087/rhfj.2010.3.1357

Topicality. Development of strategies for necrotic myocardium regeneration has considerable practical interest. Objective. To study the influence of intracoronary transplantation of bone marrow mononuclear cells (BMMC) on clinical and functional status, parameters of left ventricular remodeling and its safety in patients with postinfarction cardiosclerosis (PICS), and CHF. Materials and methods. In total 24 patients with extensive postinfarction cardiosclerosis, LVEF <40 %, without hemodynamically significant lesion of infarct-unrelated coronary artery (IUA), with comprehensive treatment of CHF, were randomized blindly to stem cell therapy group (n=12) and control (n=12). First group received BMMC intracoronary or to the pool of infarct-related artery (IRA, n=6) or into the pool of IUA (n=6). The control group included patients with revascularized (n=6), and not revascularized IRA (n=6). Follow-up duration was 6 months. At baseline, after 3 and 6 months assessement of clinical and functional status, indicators LV remodeling / perfusion, as well as safety of therapy was performed. Results. Intracoronary transplantation of BMMC in patients with PICS and decreased LV ejection fraction, adequate revascularization and optimally matched treatment, can promote just moderate improvement of LV myocardial contractility without significant reduction of cicatricial lesion zone. This effect is accompanied by significant increase of physical stress tolerance. Further research of efficacy and safety of cell therapy in this group of patients are needed.
  1. Strauer BE, Brehm M, Zeus T et al. Regeneration of human infarcted heart muscle by intracoronary autologous bone marrow cell transplantation in chronic coronary artery disease: the IACT Study. J Am Coll Cardiol. 2005;46 (9):1651–1658.
  2. Assmus B, Schachinger V, Teupe C et al. Transplantation of progenitor cells and regeneration enhancement in acute myocardial infarction (TOPCARE-AMI). Circulation. 2002;106 (24):3009–3017.
  3. Wollert KC, Meyer GP, Lotz J et al. Intracoronary autologous bone-marrow cell transfer after myocardial infarction: the BOOST randomised controlled clinical trial. Lancet. 2004;364 (9429):141–148.
  4. Meyer GP, Wollert K, Lotz J et al. Intracoronary bone marrow cell transfer after myocardial infarction: eighteen months’ follow-up data from the randomized, controlled BOOST (BOne marrOw transfer to enhance ST-elevation infarct regeneration) trial. Circulation. 2006; 113 (10):1287–1294.
  5. Janssens S, Dubois C, Bogaert J et al. Autologous bone marrow-derived stem-cell transfer in patients with ST-segment elevation myocardial infarction: double-blind, randomised trolled trial. Lancet. 2006; 367 (9505):113–121.
  6. Schachinger V, Erbs S, Elsasser A et al. Intracoronary bone marrow-derived progenitor cells in acute myocardial infarction. N Engl J Med. 2006;355 (12):1210–1221.
  7. Lunde K, Solheim S, Aakhus S et al. Intracoronary injection of mononuclear bone marrow cells in acute myocardial infarction. N Engl J Med. 2006;355 (12):1199–1209.
  8. Bartunek J, Vanderheyden M, Vandekerckhove B et al. Intracoronary injection of CD133‑positive enriched bone marrow progenitor cells promotes cardiac recovery after recent myocardial infarction: feasibility and safety. Circulation. 2005;112 (9 Suppl):I178‑I183.
  9. Kang HJ, Kim HS, Zhang SY et al. Effects of intracoronary infusion of peripheral blood stem-cells mobilised with granulocyte-colony stimulating factor on left ventricular systolic function and restenosis after coronary stenting in myocardial infarction: the MAGIC cell randomized clinical trial. Lancet. 2004;363 (9411):751–756.
  10. Chen SL, Fang WW, Ye F et al. Effect on left ventricular function of intracoronary transplantation of autologous bone marrow mesenchymal stem cell in patients with acute myocardial infarction. Am J Cardiol. 2004;94 (1):92–95.
  11. Manginas A, Goussetis E, Koutelou M et al. Pilot study to evaluate the safety and feasibility of intracoronary CD133 (+) and CD133 (-) CD34 (+) cell therapy in patients with nonviable anterior myocardial infarction. Catheter Cardiovasc Interv. 2007;69 (6):773–781.
  12. Kuethe F, Richartz BM, Kasper C et al. Autologous intracoronary mononuclear bone marrow cell transplantation in chronic ischemic cardiomyopathy in humans. Int J Cardiol. 2005;100 (3):485–491.
  13. Erbs S, Linke A, Adams V et al. Transplantation of blood-derived progenitor cells after recanalization of chronic coronary artery occlusion: first randomized and placebo-controlled study. Circ Res. 2005;97 (8):756–762.
  14. Assmus B, Honold J, Schachinger V et al. Transcoronary transplantation of progenitor cells after myocardial infarction. N Engl J Med. 2006;355 (12):1222–1232.
  15. Yelda T, Berrin U, Murat S et al. Intracoronary stem cell infusion in heart transplant candidates. Tohoku J Exp Med. 2007;213 (2):113–120.
  16. Gao LR, Wang ZG, Zhu ZM et al. Effect of intracoronary transplantation of autologous bone marrow-derived mononuclear cells on outcomes of patients with refractory chronic heart failure secondary to ischemic cardiomyopathy. Am J Cardiol. 2006;98 (5):597–602.
  17. Strauer BE, Brehm M, Schannwell CM. The therapeutic potential of stem cells in heart disease Cell Prolif. 2008;41 (1):126–145.
  18. Frangogiannis NG, Smith CW, Entman ML. The inflammatory response in myocardial infarction. Cardiovasc Res. 2002;53 (1):31–47.
  19. Bartunek J, Wijns W, Heyndrickx GR et al. Timing of intracoronary bone-marrow-derived stem cell transplantation after ST-elevation myocardial infarction. Nat Clin Pract Cardiovasc Med. 2006;3 (1):S52–56.
  20. Gyongyosi M, Lang I, Dettke M et al. Combined delivery approach of bone marrow mononuclear stem cells early and late after myocardial infarction: the MYSTAR prospective, randomized study. Nat Clin Pract Cardiovasc Med. 2009;6 (1):70–81.
  21. Abdel-Latif A, Bolli R, Tleyjeh IM et al. Adult bone marrow-derived cells for cardiac repair: a systematic review and meta-analysis. Arch Intern Med. 2007;167 (10):989–997.
Bazhan S.S., Sychev A.V., Mareev V.Y. et al. Efficacy and safety of intracoronary transplantation of bone marrow mononuclear cells in patients with postinfarction myocardial changes and heart failure. Russian Heart Failure Journal. 2010;11(2):139-147.

To access this material please log in or register

Register Authorize
Ru En