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Updated: Jun 5, 2026
Intramyocardial Cell Delivery: Observations in Murine Hearts
Published on: January 24, 2014
Intramyocardial bone marrow-derived mononuclear cell injection for chronic myocardial ischemia: the effect on
Jan van Ramshorst1, M Louisa Antoni, Saskia L M A Beeres
1Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, Leiden, The Netherlands.
Insights
Intramyocardial bone marrow cell injection improved diastolic function and reduced filling pressures in patients with chronic myocardial ischemia. This therapy offers a promising approach for managing heart failure symptoms.
Area of Science:
- Cardiology
- Regenerative Medicine
- Biomedical Engineering
Background:
- Chronic myocardial ischemia significantly impairs cardiac diastolic function.
- Current treatments for diastolic dysfunction in ischemia have limitations.
Purpose of the Study:
- To evaluate the impact of intramyocardial bone marrow cell injection on diastolic function in patients with chronic myocardial ischemia.
Main Methods:
- Randomized trial substudy involving 50 patients.
- Echocardiography, strain analysis, and MRI-derived transmitral flow measurements were used.
- Diastolic function assessed before and 3 months after intervention.
Main Results:
- Bone marrow cell injection significantly improved left ventricular ejection fraction compared to placebo.
- The E/E' ratio, an indicator of filling pressure, improved significantly in the bone marrow cell group.
- MRI revealed a significant increase in the E/A peak flow ratio, driven by enhanced early diastolic filling.
Conclusions:
- Intramyocardial bone marrow cell injection demonstrates a beneficial effect on myocardial relaxation.
- The therapy positively impacts filling pressures in patients with chronic myocardial ischemia.
- This approach holds potential for improving diastolic function in ischemic heart disease.
Background:
The present substudy of a recently published randomized trial aimed to investigate the effect of intramyocardial bone marrow cell injection on diastolic function in patients with chronic myocardial ischemia.
Methods And Results:
In a total of 50 patients, diastolic function was evaluated before and 3 months after bone marrow cell injection using standard echocardiography and strain analysis. In addition, MRI-derived transmitral flow measurements were obtained in a subset of 36 patients. Left ventricular ejection fraction increased from 50±5% to 54±7% in the bone marrow cell group, which was a significant improvement as compared with the placebo group (52±5% versus 51±7%, P=0.001). Filling pressure estimate E/E' ratio improved from 14±5 at baseline to 12±4 at 3 months in the bone marrow cell group, whereas no improvement was observed in the placebo group (13±4 versus 13±5). The improvement in E/E' ratio was significantly larger in the bone marrow cell group (P=0.008). Furthermore, the E/A peak flow ratio as assessed by MRI showed a significant increase in the bone marrow cell group as compared with the placebo group (+0.16±0.25 versus -0.04±0.21, P=0.01), which was mainly related to an increase in the early (E) peak flow rate in the bone marrow cell group (from 407±96 mL/s to 468±110 mL/s, P=0.009 as compared with the placebo group).
Conclusions:
The current study demonstrates that intramyocardial bone marrow cell injection is associated with a beneficial effect on myocardial relaxation and filling pressures in patients with chronic myocardial ischemia.
