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Intramyocardial Cell Delivery: Observations in Murine Hearts
Published on: January 24, 2014
Intracoronary autologous mononucleated bone marrow cell infusion for acute myocardial infarction: results of the
Jérôme Roncalli1, Frédéric Mouquet, Christophe Piot
1Fédération de Cardiologie, CHU Toulouse, INSERM U858, Institut de Médecine Moléculaire de Rangueil, Université Paul Sabatier, Toulouse, France.
European Heart Journal
|December 4, 2010
Summary
Autologous bone marrow cells (BMCs) improved myocardial viability in patients post-acute myocardial infarction (AMI) in multivariate analysis. Further trials are needed to confirm efficacy and identify patient subgroups benefiting from cardiac cell therapy.
Area of Science:
- Cardiology
- Regenerative Medicine
- Biomedical Engineering
Background:
- Intracoronary autologous bone marrow cells (BMCs) show modest cardiac function improvement post-acute myocardial infarction (AMI).
- The impact of BMC therapy on myocardial viability in patients with reduced left ventricular ejection fraction (LVEF) after AMI remains unclear.
- This study aimed to assess BMC therapy's effect on myocardial viability and identify predictors of improvement.
Purpose of the Study:
- To evaluate the efficacy of intracoronary autologous bone marrow cell (BMC) therapy in improving myocardial viability.
- To identify predictive factors for enhanced myocardial viability in patients following acute myocardial infarction (AMI).
- To assess the impact of BMC therapy on patients with decreased left ventricular ejection fraction (LVEF) post-AMI.
Main Methods:
- A randomized multicentre study involving 101 patients with AMI, successful reperfusion, LVEF ≤45%, and reduced myocardial viability.
- Patients were randomized into a control group (n=49) or a bone marrow cell (BMC) group (n=52).
- Myocardial viability was assessed 3 months post-AMI using resting Tl201-SPECT and radionuclide angiography.
Main Results:
- Myocardial viability improved in 34% of patients receiving BMCs versus 16% in the control group (P=0.06).
- Multivariate analysis revealed a significant improvement in myocardial viability in the BMC group compared to the control group (P=0.03).
- Active smoking (P=0.04) was associated with adverse outcomes, while microvascular obstruction showed a positive trend (P=0.07).
Conclusions:
- Intracoronary autologous BMC administration was associated with improved myocardial viability in multivariate analysis.
- Univariate analysis did not show a significant improvement, highlighting the need for further investigation.
- A large international trial is recommended to confirm cardiac cell therapy efficacy and define patient subgroups that benefit most.
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