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Updated: Jul 19, 2026
Intramyocardial Cell Delivery: Observations in Murine Hearts
Published on: January 24, 2014
Intracoronary infusion of autologous bone marrow cells and left ventricular function after acute myocardial
M Hristov1, Nicole Heussen, A Schober
1Institute for Molecular Cardiovascular Research and Interdisciplinary Center for Clinical Research BIOMAT, RWTH University Hospital Aachen, Aachen, Germany.
Insights
Intracoronary infusion of autologous bone marrow cells (BMC) shows potential benefit for left ventricular function after acute myocardial infarction (AMI). Further large-scale trials are needed to confirm efficacy and identify optimal patient selection for this supportive therapy.
Area of Science:
- Regenerative Medicine
- Cardiology
- Cell Therapy
Background:
- Acute myocardial infarction (AMI) can impair left ventricular function.
- Intracoronary infusion of autologous bone marrow cells (BMC) is being investigated as a supportive therapy for AMI.
- Previous studies show controversial results due to small sample sizes and differing designs.
Purpose of the Study:
- To systematically review randomized controlled trials (RCTs) evaluating the efficacy of intracoronary autologous non-mobilized BMC combined with standard therapy versus standard therapy alone in patients with AMI.
- To assess the impact of BMC infusion on left ventricular ejection fraction (LVEF) post-AMI.
Main Methods:
- Systematic review of primary controlled randomized clinical studies.
- Included studies compared intracoronary transfer of autologous non-mobilized BMC with standard therapy against standard therapy alone.
- Analysis focused on changes in LVEF from baseline to follow-up.
Main Results:
- Five RCTs were identified, with three also being placebo- and bone marrow aspiration-controlled.
- A total of 482 patients completed follow-up (241 received BMC infusion).
- A statistically significant improvement in LVEF was observed in the BMC-treated group compared to the control group (P = 0.04).
Conclusions:
- Intracoronary transplantation of BMC appears to be a safe and potentially beneficial adjunctive therapy for AMI, supporting improved left ventricular function.
- The observed functional improvement was moderate, and study designs were heterogeneous.
- Large-scale, double-blind, randomized, placebo-controlled multi-center trials are warranted to further validate efficacy and define patient subgroups that benefit most from BMC infusion.
Abstract:
Recent clinical studies have demonstrated that intracoronary infusion of autologous bone marrow cells (BMC) in conjunction with standard treatment may improve left ventricular function after an acute myocardial infarction (AMI). However, the results of these studies remain controversial, as the studies were relatively small in size and partially differed in design. We reviewed primary controlled randomized clinical studies comparing intracoronary transfer of autologous non-mobilized BMC combined with standard therapy versus standard therapy alone in patients with AMI. We identified five randomized controlled clinical trials, three of which were also placebo- and bone marrow aspiration-controlled. Non-mobilized BMC were infused into the revascularized coronary target artery 6.6 +/- 6.1 days after AMI. The mean follow- up period of 5.2 +/- 1.1 months was completed by 482 patients, 241 of which received infusion of BMC. The effect of BMC on left ventricular ejection fraction (LVEF) as a major functional parameter was evaluated. Analyzing the overall effect on the change in LVEF between baseline and follow-up value revealed a significant improvement in the BMCtreated group as compared to the control group (P = 0.04). Thus, considering the increase in LVEF during follow-up, transplantation of BMC may be a safe and beneficial procedure to support treatment of AMI. However, the functional improvement observed with this form of therapy was altogether relatively moderate and the studies were heterogeneous in design. Hence, further efforts aiming at large-scale, double-blind, randomized and placebo-controlled multi-center trials in conjunction with better definition of patients, which benefit from BMC infusion, appear to be warranted.
