Abstract 15218: Intramyocardial Injection of Bone Marrow Mononuclear Cells in Patients with Chronic Myocardial Ischemia: an Intra-Patient Comparison
Purpose In previous trials, intramyocardial bone marrow cell (BMC) injection has demonstrated to improved myocardial perfusion (MP) and anginal symptoms in patients with chronic myocardial ischemia. However, the reported beneficial effect varies between trials, possibly due to unknown bias between treatment groups. Therefore, in order to exclude potential patient-specific biasing factors, an intra-patient comparison on the effect of BMC injection versus placebo injection was performed.
Methods Sixteen patients with chronic myocardial ischemia (14 male, 64±10 years), who recently received intramyocardial placebo injection in the setting of a randomized cell therapy trial, were enrolled. Using the NOGA-system, injection of 100x106 BMC was performed. Anginal symptoms and quality of life (QoL) were evaluated at baseline, 3 and 6 months. Single-photon emission computed tomography and magnetic resonance imaging were performed at baseline and 3 months to assess MP and left ventricular (LV) function.
Results Improvement in summed stress score was significantly greater (P=0.03) after BMC injection compared to placebo (24.7±4.5 to 21.9±3.9, P<0.01 vs. 24.6±4.8 to 23.8±5.0, P=0.02). LV ejection fraction remained unchanged. After BMC injection, Canadian Cardiovascular Society angina class improved from 3.1±0.6 to 2.4±0.9 at 6 months (P=0.02), whereas placebo injection caused no significant change. After 6 months, improvement in QoL was significantly greater (P=0.01) after BMC injection compared to placebo (59%±13% to 69%±16%, P<0.01 vs. 59±9 to 62±11, P<0.01). (Figure 1)
Conclusion The present study demonstrated a favorable effect of intramyocardial BMC injection on MP and anginal symptoms as compared to placebo treatment, using an intra-patient comparison model.
- © 2011 by American Heart Association, Inc.