title: Improvement of collateral perfusion and regional function by implantation of peripheral blood mononuclear cells into ischemic hibernating myocardium.
abstract: OBJECTIVE
  This study was performed to evaluate the angiogenic effect of implantation of peripheral blood mononuclear cells (PB-MNCs) compared with bone marrow mononuclear cells (BM-MNCs) into ischemic hibernating myocardium.
  
  
  RESULTS
  A NOGA electromechanical system was used to map the hibernating region and to inject cells. PB-MNCs and BM-MNCs contained similar levels of vascular endothelial growth factor and basic fibroblast growth factor, whereas contents of angiogenic cytokines (interleukin-1beta and tumor necrosis factor-alpha) were larger in PB-MNCs. Numbers of endothelial progenitors were approximately 500-fold higher in BM-MNCs. In BM-MNC-implanted myocardia of pigs, an increase in systolic function (ejection fraction from 33% to 52%) and regional blood flow (2.1-fold) and a reduction of the ischemic area (from 29% to 8%) were observed. PB-MNC implantation reduced the ischemic area (from 31% to 17%), the extent of which was less than that seen with BM-MNCs. In saline-implanted myocardium, the ischemic area expanded (from 28% to 38%), and systolic function deteriorated. Angiography revealed an increase in collateral vessel formation by PB-MNC or BM-MNC implantation. Capillary numbers were increased 2.6- and 1.7-fold by BM-MNC and PB-MNC implantation, respectively. BM-MNCs but not PB-MNCs were incorporated into neocapillaries.
  
  
  CONCLUSIONS
  Catheter-based implantation of PB-MNCs can effectively improve collateral perfusion and regional function in hibernating ischemic myocardium by its ability to mainly supply angiogenic factors and cytokines.
authors.affiliation: Department of Medicine II and Cardiovascular Center, Kansai Medical University, Moriguchi, Osaka, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kamihata
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Matsubara
authors.forename: Takashi
authors.initials: T
authors.lastname: Nishiue
authors.forename: Soichiro
authors.initials: S
authors.lastname: Fujiyama
authors.forename: Katsuya
authors.initials: K
authors.lastname: Amano
authors.forename: Osamu
authors.initials: O
authors.lastname: Iba
authors.forename: Takanobu
authors.initials: T
authors.lastname: Imada
authors.forename: Toshiji
authors.initials: T
authors.lastname: Iwasaka
mesh_terms: D043925:Angiogenesis Inducing Agents / Q000378:metabolism; D000818:Animals; D001854:Bone Marrow Cells / Q000737:chemistry / Q000502:physiology; D016026:Bone Marrow Transplantation; D002196:Capillaries / Q000737:chemistry / Q000166:cytology; D006328:Cardiac Catheterization / Q000379:methods; D019070:Cell Lineage; D017023:Coronary Angiography / Q000379:methods; D003326:Coronary Circulation / Q000502:physiology*; D003331:Coronary Vessels / Q000737:chemistry / Q000166:cytology / Q000502:physiology; D022062:Electrophysiologic Techniques, Cardiac / Q000379:methods; D004730:Endothelium, Vascular / Q000737:chemistry / Q000166:cytology / Q000378:metabolism / Q000502:physiology; D016130:Immunophenotyping / Q000379:methods; D007963:Leukocytes, Mononuclear / Q000737:chemistry / Q000502:physiology* / Q000637:transplantation*; D009200:Myocardial Contraction / Q000502:physiology*; D017202:Myocardial Ischemia / Q000628:therapy*; D018919:Neovascularization, Physiologic / Q000502:physiology; D010477:Perfusion / Q000379:methods*; D020127:Recovery of Function / Q000502:physiology; D033581:Stem Cell Transplantation / Q000379:methods; D013234:Stem Cells / Q000737:chemistry / Q000378:metabolism / Q000502:physiology; D013552:Swine
chemical_list: D043925:Angiogenesis Inducing Agents