Abstract 794: Regeneration of Human Infarcted Heart Function by Intracoronary Autologous Bone Marrow Cell Transplantation in Chronic Coronary Heart Disease. : Controlled study with Intracoronary Autologous Mononuclear Bone Marrow Cell Transplantation (IACT-Study)
Introduction: Remodeling of the left ventricle (LV) after myocardial infarction (MI) represents a major cause of infarct-related heart failure and death. After acute myocardial infarction transplantation of bone marrow cells (BMCs) improve cardiac function. We investigated cardiac performance of intracoronary transplantation of autologous BMCs in patients with chronic ischemic heart disease, suffered from transmural myocardial infarction
Methods and Results: We treated 45 consecutive patients (49±12 years) with chronic myocardial infarction by intracoronary transplantation of autologous bone marrow mononuclear cells (BMCs) and compared them with a consecutive enrolled representative control group (n=25, 52±10 years). A myocardial infarction had been treated acutely with percutaneous transluminal coronary angioplasty and most of the patients needed stent implantation. Bone marrow was harvested from the hip (~80 ml). The median number of mononuclear cells harvested after overnight culture was 98 x 106. After 3 months in the transplantation group, infarct size was reduced by 23%, and global left ventricular ejection fraction (+12%) as well as infarction wall movement velocity (+42%) increased significantly (p<0.05), while in the randomized control group no significant changes were observed during 3 months follow-up in infarct size (25±11 to 24±9%), in left ventricular ejection fraction (48±10 to 46±12%) and in wall movement velocity of infarcted area (1.78±0.84 to 1.74±0.82cm/s). PTCA alone had no effect on left ventricular function in this chronic coronary patients. After bone marrow cell transplantation, there was an improvement of maximum oxygen uptake (VO2max, +11%) and of regional 18F-Fluor-Desoxy-Glucose (FDG) uptake (PET) into infarcted tissue (+13%).
Conclusions: These results demonstrate that regeneration of infarcted and chronically avital tissue can be realized in humans by selective intracoronary bone marrow mononuclear cell transplantation. This regeneration is most probably due to neogenesis of cardiac tissue, of both myocytes and of coronary blood vessels.