Long-Term Outcome of Intra-Myocardial Injection of Autologous Bone Marrow Mononuclear Cells Combined with Isolated Coronary Artery Bypass Grafting for Patients with Chronic Ischemic Heart Failure

Abstract

Intra-myocardial injection of aBMMNC transplantation on arrested heart during CABG is a safe procedure based on a longer period observation. The patients with chronic ischemic heart failure can benefit from aBMMNCs transplantation in the short-term (6 months) demonstrated by improved global LVEF compared with the control group; however, this additional benefit dimed with time as showed by 24-month clinical and echocardiographic follow-up results.

Follow-up of intramyocardial bone marrow mononuclear cell transplantation beyond 10 years

“…Safety of BMMC treatment has been previously shown by us 11 and other studies 13 , and some studies have even shown reduced mortality in BMMC treated patients 8 . Yet, the trend of mortality, MACCEs or MACEs are not favorable for the treatment group—although none of these parameters resulted statistically significant.…”

Autologous bone marrow stem cell transplantation for patients undergoing coronary artery bypass grafting: a meta-analysis of 22 randomized controlled trials

“…These 4 literature [ 13 , 31 – 33 ] reports one trial. The final analysis included 22 independent RCTs [ 4 – 24 , 30 ]. A flow chart for the study selection process is presented in Fig.…”

“…There are some points of view in previous studies. Wang et al [ 30 ] have commented that paracrine effects of BMMNCs transplantation and the intervention time may play a key role in the outcome, the left ventricular remodeling is more likely to be prohibited and the left ventricular systolic function obtains the opportunity to improve steadily in the long term while transplanted at the acute myocardial infarction setting, limited reduction in MI size, short-term improvement in LV function, and disappearance of paracrine effects over time when BMMNCs is transplanted at old myocardial infarction setting in which the left ventricular remodeling has already developed and the paracrine effect of BMMNCs is mainly acting on the transitional zone of old myocardial infarction. Wang et al [ 10 ] suggested that transplantation during off-pump coronary artery bypass grafts could reduce ischemia and reperfusion injury and restore vascular supply, thereby increasing stem cell survival rate and avoiding inflammation, loss of survival signal of extracellular matrix components and release of ischemic cardiac cytotoxic factors leading to high mortality of stem cells after transplantation.…”

“…Naseri et al [ 12 ] have commented that previous animal experiments have shown that the transplanted cells integrate into the new environment and form new vasculature and myocardium. Wang et al [ 30 ] have commented that a series of experimental studies have shown that BMMNCs can express a large number of cytokines, prevent cardiomyocyte apoptosis, promote angiogenesis, and recruit endogenous stem cells for cell regeneration and fusion. Wang et al [ 10 ] have suggested that the suppression of fibrosis and the improvement of ventricular remodeling induced by BMCs transplantation may play important roles in improving cardiac function.…”

“…In addition, some studies [ 4 , 6 , 8 – 11 , 13 , 18 , 30 ] did not directly report the mean and SD of LVEF BMSC change and LVEF CABG change . The mean of the LVEF BMSC change and LVEF CABG change can be calculated by the difference between the means of the LVEF baseline and LVEF follow-up .…”