Intracoronary infusion of autologous mononuclear bone marrow cells in patients with acute myocardial infarction treated with primary PCI: Pilot study of the multicenter HEBE trial
- 15 February 2008
- journal article
- research article
- Published by Wiley in Catheterization and Cardiovascular Interventions
- Vol. 71 (3), 273-281
- https://doi.org/10.1002/ccd.21337
Abstract
Objective: This study was a pilot trial to determine safety and feasibility of intracoronary infusion of mononuclear bone marrow cells (MBMC) in patients with acute myocardial infarction (MI). Background: Studies reporting the effect of MBMC therapy on improvement of left ventricular (LV) function have shown variable results. The HEBE trial is a large multicenter, randomized trial that currently enrolls patients. Prior to this trial we performed a pilot study. Methods: Twenty‐six patients with a first acute MI were prospectively enrolled in eight centers. Bone marrow aspiration was performed at a median of 6 days after primary PCI (interquartile range, 5–7 days). MBMC were isolated by gradient centrifugation and were infused intracoronary the same day. All patients underwent magnetic resonance imaging before cell infusion and after 4 months. Clinical events were assessed up to 12 months. Results: Within 10 hr after bone marrow aspiration, 246 ± 133 × 106 MBMC were infused, of which 3.9 ± 2.3 × 106 cells were CD34+. In one patient, this procedure was complicated by local dissection. LV ejection fraction significantly increased from 45.0 ± 6.3% to 47.2 ± 6.5% (P = 0.03). Systolic wall thickening in dysfunctional segments at baseline improved with 0.9 ± 0.7 mm (P < 0.001). Infarct size decreased 37% from 17.8 ± 8.2 to 11.2 ± 4.2 gram (P < 0.001). During 12‐month follow‐up, 3 additional revascularizations were performed and an ICD was implanted in one patient, 3 weeks after PCI. Conclusion: In patients with acute MI, intracoronary infusion of MBMC is safe in a multicenter setting. At 4‐month follow‐up, a modest increase in global and regional LV function was observed, with a concomitant decrease in infarct size.Keywords
This publication has 31 references indexed in Scilit:
- Intracoronary Injection of Mononuclear Bone Marrow Cells in Acute Myocardial InfarctionNew England Journal of Medicine, 2006
- Intracoronary Bone Marrow Cell Transfer After Myocardial InfarctionCirculation, 2006
- Autologous bone marrow-derived stem-cell transfer in patients with ST-segment elevation myocardial infarction: double-blind, randomised controlled trialThe Lancet, 2006
- Intracoronary autologous bone-marrow cell transfer after myocardial infarction: the BOOST randomised controlled clinical trialThe Lancet, 2004
- Haematopoietic stem cells do not transdifferentiate into cardiac myocytes in myocardial infarctsNature, 2004
- Left Ventricular Remodeling After Primary Coronary AngioplastyCirculation, 2002
- Transendocardial delivery of autologous bone marrow enhances collateral perfusion and regional function in pigs with chronic experimental myocardial ischemiaJournal of the American College of Cardiology, 2001
- Bone marrow cells regenerate infarcted myocardiumNature, 2001
- Neovascularization of ischemic myocardium by human bone-marrow–derived angioblasts prevents cardiomyocyte apoptosis, reduces remodeling and improves cardiac functionNature Medicine, 2001
- Cardiac remodeling—concepts and clinical implications: a consensus paper from an international forum on cardiac remodelingJournal of the American College of Cardiology, 2000