Efficacy and long-term evaluation of intramyocardial injection of autologous CD34-enriched PBMSC in old myocardial infarction

Abstract

Aims: We have shown that autologous transplant of CD34 + -enriched peripheral-blood mononuclear cells (PBMSC) could restore depressed myocardial function, and sustain adequate myocardial function 12 months after surgery in patients with old (>one yearold) myocardial infarction. Our aim is to report the long-term morbidity and mortality efficacy of this procedure. Methods and results: Seventy patients with an old anteroseptal myocardial infarction were followed for 2 to 7 years, 35 had a revascularization procedure and received an intra-myocardial injection of autologous CD34 + -enriched PBMSC (8 × 10 8 mononuclear cells/ml including 3 × 10 7 CD34 + cells/ml)(Group A). Group B patients only had the revascularization. Abnormal pre-surgical values of LVEF (33.2% ± 4.8%), LVDV (178 ± 13.7 ml), LVSV (120 ± 16 m), LVDD (58.9 ± 3.84 mm), E and A waves without contractility in infarction area in group A patients improved to approximate normal values (50% ± 3% for LVEF; 90 ± 9.3 ml for LVDV; 80 ± 9.9 ml for LVSV; 55.3 ± 3 mm for LVDD; 5.2 ± 0.5 cm/s for E wave and 4.18 ± 0.3 cm/s for A wave) 1 year after the procedure and have remained unaltered for all the follow-up period. All the patients remain alive. Only seven patients have been readmitted to the hospital for non-myocardial related events. Group B only 11 patients continued alive to 5 years after surgery and LEVF never increased more than 6%, all of them with many hospitalizations (n ≥ 10) by heart failure events. Conclusion: Intramyocardial injection of CD34 + highly enriched PBSC represent an encouraging alternative for patients with severely scarred and dysfunctional myocardium.

CXCR4+ and SDF-1+ Bone Marrow Cells Are Mobilized into the Blood Stream in Acute Myocardial Infarction and Acute Ischemia

“…These effects have been observed in patients with Acute Myocardial Infarctions with viable tissue as well as in patients with a vast scar as a consequence of an old heart infarction episode [4] [14]- [16]. Variations in the function of the infarcted heart after cell therapy can be secondary to differences of the implanted progenitor cells [15] [16], so we conducted this study to determine the bone marrow cell populations that move in acute and chronic is chemia events such as Acute Myocardial Infarction, acute angina and chronic stable angina respectively.…”