Intramyocardial Bone Marrow Cell Injection for Chronic Myocardial Ischemia

Abstract

ONE MARROW CELL THERAPY IS currently being investigated as a new therapeutic option for patients with ischemic heart disease. The goal of this treatment is to improve myocardial perfusion and contractile performance through administration of therapeutic cells into ischemically damaged myocardium. The majority of clinical studies conducted so far investigated whether intracoronary bone marrow cell infusion could enhance functional recovery after acute myocardial infarction. 1-3 Animal model studies, however, suggested that bone marrow cell therapy may also improve myocardial perfusion and increase left ventricular (LV) function in chronic ischemia. 4,5 A number of nonrandomized clinical studies indicated the safety and feasibility of intramyocardial bone marrow cell injection. 6-9 Moreover, a beneficial effect on myocardial perfusion and LV function was presumed. Until now, only 2 smallsized randomized controlled studies assessed the effect of bone marrow cell injection in patients with chronic myocardial ischemia. 10,11 Since the results of these 2 studies were discrepant, the beneficial effect of this treatment mo-Author Affiliations are listed at the end of this article.

Cardiomyopathy and Cell Therapy: Ejection Fraction Improvement and Cardiac Muscle Mass Increasing, after a Year of Bone Marrow Stem Cells Transplantation, by Magnetic Resonance Image

“…These results were also similar to those found for chronic myocardial ischemia during a multicenter, randomized trial [21]. In 2007, 17 studies are available that assessed the changes in LV function after cell therapy, most of them indicated small improvements in LVEF (ranging from 2.9% to 9.3%) [16], we found an improvement in LEVF 7.11% after the first year and 10.05% after the second year of cell therapy, probably the literature described.…”

“…Unfortunately, organ rates are low and most of the patients on transplant waiting list died before receiving a new heart [15][16][17][18][19][20]. Therefore, a therapy capable of improving cardiac function and more accessible to the population is of great interest [21].…”

Randomized Clinical Trials in Stem Cell Therapy for the Heart - Old and New Types of Cells for Cardiovascular Repair

“…In the PROTECT-CAD trial (Tse et al, 2007), BMMC injections improved NYHA functional class, exercise time, LVEF, wall thickening and stress-induced perfusion defects. Finally, Van Ramshorst et al (van Ramshorst et al, 2009) reported better LVEF, myocardial perfusion, angina functional class, exercise capacity and quality of life after BMMC administration. ADSC have also been studied in this type of patients.…”

General Overview of the Seventh International Symposium on Stem Cell Therapy and Cardiovascular Innovations

“…Direct intramyocardial injection of bone marrow mononuclear cells guided by the NOGA system improved myocardial perfusion, left ventricular function, and anginal symptoms compared with placebo injection [8].…”