Abstract 1406: Longterm (2,5 year’s) Follow-up by Intracoronary Infusion of Autologous Mononuclear Bone Marrow Cells in Chronic Coronary Artery Disease after is Assosiated with Improvement of Left Ventricular Funktion in Human Infarcted Heart Muscle. (IACT-Study)
Background: Experimental and clinical study suggest that transplantation of autologous bone marrow mononuclear cells(BMCs) fraction has a salutary effect after postinfarcted remodeling in acute myocardial infarction and also in chronic coronary artery disease with regional left ventricular dysfunction. Recent human studies with transplantation of BMCs have shown promising longterm results. We evaluate the longterm effects on the ventricular remodeling process and the safety of this therapy.
Methods: 18 patients (age 48, ±11 years) had a stable chronical artery heart disease and suffered from myocardial infarction (27 ±31 months) before i.c. transplantation of BMCs into the reopened infarct-related artery. We compared therm with a representative control group n=18 (age 52, ±10 years). Bone marrow was harvested from the hip (~80 ml) and mononuclear cells were identified. The median number of mononuclear cells harvested was 92 × 106. All patients received a standard medication before and after cell therapy. All patients have been re-evaluated 3,12 and 30 month after cell transplantation by coronary angiography, left ventriculography, electrocardiography and 24h Holter-ECG, spiro-ergometry.
Results: After 3, 12 and 30 months in the transplantation group, infarct size was reduced after 30 month by 28% sig. (p<0.05). Global left ventricular ejection fraction increase by 15% and after 30 month as well as infarction wall movement velocity by +55% and then after 30 months increased sig. (p<0.05), while in the randomized control group no sig. changes were observed during 3,12 and after 30 months follow-up. After bone marrow cell transplantation, there was an improvement of maximum oxygen uptake in the transplantation group (VO2max, +12 and after 13 month). There was no significant change in the transplantation group in Lown Class in the long term follow up after 3,12 and 30 month.
Conclusions: These results demonstrate that intracoronary transplantation of BMCs is highly effective, in reduced infarct size, recovered global ejection fraction and wall movement velocity in chronical artery heart disease. These beneficial effects persist for at least 30 month after cell transplantation.