SummaryImpact of early bone marrow-derived mesenchymal stem cell (BMDMSC) implantation on left ventricular (LV) function after AMI was studied.Twelve mini-pigs were equally divided into placebo (AMI through left coronary artery ligation) and cell-treated groups [BMDMSCs (3.0 × 10 7 ) implanted into infarct area (IA)] with myocardium harvested by post-AMI day 90. Six healthy animals served as controls.On post-AMI day 90, magnetic resonance imaging showed a lower LV ejection fraction but higher LV dimensions in the placebo group (P < 0.003) that also had increased IAs but reduced wall thickness (P < 0.005). Pro-apoptotic gene expressions (Bax, caspase-3) and apoptotic nucleus number in IAs and peri-IAs were highest in the placebo group (P < 0.001). Inflammatory biomarker expressions (MMP-9, oxidized protein, CD40+ cells) were highest, whereas those of angiogenesis (VEGF, CD31+ cells, SDF-1α, CXCR4) and myocardium-preservation (connexin43, troponin-I, cytochrome-C) were lowest in the placebo group (P < 0.01).BMDMSC implantation preserved LV function and alleviated remodeling at post-AMI day 90. ( 6-9) Indeed, some studies have reported that SC therapy exhibited only temporary 5,8,9) or minimal 10) effectiveness, or was even ineffective [11][12][13][14][15][16] in improving global LV ejection fraction (LVEF) in patients after acute myocardial infarction (AMI). Further analysis of these clinical trials revealed that stem cell therapy was performed only several days after 5,8,9,[11][12][13] rather than immediately after AMI. Thus, interpretation of the results of these experimental and clinical investigations are difficult because of multiple variables, including the differences in experimental and trial design, cell type used, timing of cell delivery, and parameters for outcome assessment. [1][2][3][4][5][6][7][8][9][10][11][12][13]17) To date, although there is still no definite explanation to account for the discrepancy in findings in the literature, [1][2][3][4][5][6][7][8][9][10][11][12][13] it is rational to believe that two factors are crucial in the success of SC therapy in improving ischemia-related LV dysfunction based on the results of previous reports, 4,5,[7][8][9][10][11][12][13] in other words, a larger number of SCs to be implanted 5,11,18) and an early timing of implantation [19][20][21] in the ischemic zone after AMI. Although small animals are frequently utilized in AMI experimentation From the