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Updated: Apr 15, 2026
Intramyocardial Cell Delivery: Observations in Murine Hearts
Published on: January 24, 2014
Intramyocardial bone marrow mononuclear cell transplantation in ischemic heart failure: Long-term follow-up
Miia Lehtinen1, Tommi Pätilä1, Esko Kankuri2
1Department of Cardiothoracic Surgery, Heart and Lung Center, Helsinki University Central Hospital.
Insights
Long-term results show that combining bone marrow mononuclear cells (BMMCs) with coronary artery bypass grafting (CABG) for heart failure does not improve cardiac function but significantly reduces scar size.
Area of Science:
- Cardiology
- Regenerative Medicine
- Cell Therapy
Background:
- Limited long-term data exists for bone marrow mononuclear cell (BMMC) therapy in chronic ischemic heart failure.
- Previous 1-year follow-up showed encouraging results for combined BMMC and coronary artery bypass grafting (CABG).
Purpose of the Study:
- To evaluate the long-term efficacy and safety of BMMC therapy combined with CABG in patients with chronic ischemic heart failure.
Main Methods:
- 36 patients from an original randomized, double-blind study received extended follow-up.
- Assessments included magnetic resonance imaging, pro-B-type natriuretic peptide levels, patient records, and SF-36 quality of life survey.
- BMMC or vehicle injections were administered into the myocardial infarction border zone during CABG.
Main Results:
- Median follow-up was over 5 years; no significant differences in cardiac function (ejection fraction, wall thickening) or quality of life were observed between groups.
- Pro-B-type natriuretic peptide levels did not differ significantly between the BMMC and control groups.
- A significant reduction in scar size was observed in the BMMC group compared to controls (p=0.011).
Conclusions:
- Combining intramyocardial BMMC therapy with CABG does not improve cardiac function in the long term for chronic ischemic heart failure.
- This combined therapy demonstrates a sustained ability to reduce myocardial scar size.
- BMMC therapy may offer a potential benefit in tissue remodeling post-myocardial infarction.
Background:
Long-term results regarding treatment of chronic ischemic heart failure with bone marrow mononuclear cells (BMMCs) have been few. We received encouraging results at the 1-year follow-up of patients treated with combined coronary artery bypass grafting (CABG) and BMMCs, so we decided to extend the follow-up.
Methods:
The study patients had received injections of BMMCs or vehicle into the myocardial infarction border area during CABG in a randomized and double-blind manner. We could contact 36 of the 39 patients recruited for the original study. Pre-operatively and after an extended follow-up period, we performed magnetic resonance imaging, measured pro-B-type amino-terminal natriuretic peptide, reviewed patient records from the follow-up period, and determined current quality of life with the Medical Outcomes Study Short-Form 36 (SF-36) Health Survey.
Results:
The median follow-up time was 60.7 months (interquartile range [IQR], 45.1-72.6 months). No statistically significant difference was detected in change of pro-B-type amino-terminal natriuretic peptide values or in quality of life between groups. The median change in left ventricular ejection fraction was 4.9% (IQR, -2.1% to 12.3%) for controls and 3.9% (IQR, -5.2% to 10.2%) for the BMMC group (p = 0.647). Wall thickening in injected segments increased by a median of 17% (IQR, -5% to 30%) for controls and 15% (IQR, -12% to 19%) for BMMC patients (p = 0.434). Scar size in injected segments increased by a median of 2% (IQR, -7% to 19%) for controls but diminished for BMMC patients, with a median change of -17% (IQR, -30% to -6%; p = 0.011).
Conclusions:
In the treatment of chronic ischemic heart failure, combining intramyocardial BMMC therapy with CABG fails to affect cardiac function but can sustainably reduce scar size, even in the long-term.
