Direct cardiac injection of G-CSF mobilized bone-marrow stem-cells improves ventricular function in old myocardial...

Area of Science:

• Cardiology
• Regenerative Medicine
• Stem Cell Therapy

Background:

• Autologous bone marrow stem cells (BMSC) are effective after acute myocardial events.
• Limited data exists on BMSC efficacy in patients with old (>1 year) myocardial infarction.
• Assessing novel stem cell therapies for chronic cardiac dysfunction is crucial.

Purpose of the Study:

• To evaluate the efficacy of CD34(+)-enriched peripheral blood cells for restoring myocardial function in patients with old myocardial infarction.
• To determine if intramyocardial injection of these cells can reverse long-term cardiac damage.
• To assess the safety and hemodynamic impact of this cell-based therapy.

Main Methods:

• Five patients with old myocardial infarction received peri-infarction injections of CD34(+)-enriched peripheral mononuclear cells post-revascularization.
• Peripheral blood cells were obtained by apheresis and enriched for CD34+ cells.
• Ventricular hemodynamic parameters were monitored up to 28 weeks post-injection, with two patients followed for over 52 weeks.

Main Results:

• Significant improvement in ventricular hemodynamic parameters, including left ventricular ejection fraction, was observed 28 weeks post-injection.
• Left ventricular diastolic volume, systolic volume, and diastolic diameter approached normal values.
• No instances of restenosis were reported, and long-term follow-up showed sustained normal parameters in two patients.

Conclusions:

• Intramyocardial injection of CD34(+) enriched peripheral blood cells is an encouraging procedure for treating severely scarred and dysfunctional myocardium.
• This easily obtainable cell source offers a potential therapeutic strategy for patients with chronic heart damage post-myocardial infarction.
• The study highlights the potential of peripheral blood-derived stem cells in cardiac regeneration.