Abstract 14675: Efficacy of Intramyocardial Injection of Bone Marrow Cells in Chronic Myocardial Disease is Influenced by Anatomical Location of Injection Site
Background: Intramyocardial injection of bone marrow cells (BMC) improves myocardial perfusion in patients with chronic myocardial disease. Efficacy of BMC treatment may be influenced by the anatomical location of the myocardial ischemia since positioning of the injection catheter can be difficult in certain areas and because the local effect of BMC treatment may vary between injection sites. To assess the influence of the anatomical location on BMC treatment effect, the current study evaluates the effect of BMC treatment at different injection sites.
Methods and Results: A total of 96 patients with chronic myocardial disease (84 male) underwent intramyocardial BMC injection (NOGA system) in regions with stress-inducible ischemia on Tc-99m tetrofosmin SPECT. The summed stress score, a 17-segment score for myocardial perfusion during stress, was calculated at baseline and 3 months follow up to assess treatment effect at each injected segment. The mean percentage of injected segments with improved summed stress score was 56.1±15.6% (range 16 - 80%). Summed stress score improved in 69.5% (n=105) of the combined basal ventricular segments, compared to 56.0% (n=141), in the combined mid ventricular segments and 43.0% (n=107) in the combined distal ventricular segments (P<0.01). Assessment of improved perfusion based on coronary perfusion territories demonstrated an improvement of 57.1% (n=103) in the combined anteroseptal segments, 52.9% (n=85) in the combined lateral segments and 58.6% (n=149) in the inferoposterior segments (P=0.59).
Conclusion: The present study shows that intramyocardial BMC injection results in improved myocardial perfusion in the majority of injected segments. The percentage of improved segments was highest in the basal ventricular segments. No differences in perfusion improvement were observed between coronary perfusion territories.
- © 2011 by American Heart Association, Inc.