Effect of mobilization of bone marrow stem cells by granulocyte colony stimulating factor on clinical symptoms, left ventricular perfusion and function in patients with severe chronic ischemic heart disease.
OBJECTIVE
A phase I safety and efficacy study with granulocyte colony stimulating factor (G-CSF) mobilization of bone marrow stem cells to induce vasculogenesis in patients with severe ischemic heart disease (IHD) was conducted.


METHODS
29 patients with IHD participated in the study. Thirteen patients were treated with G-CSF for 6 days and 16 patients served as controls. G-CSF treatment was without any serious adverse events. Four patients were "poor mobilizers" with a maximal increase in CD34+ cells to 5,000+/-700/mL blood (mean+/-S.D.) compared to 28,900+/-5,100/mL blood in "mobilizers". At the follow-up, G-CSF treated had improved in CCS classification, NTG consumption and angina attacks, but the controls only in CCS classification. No difference was seen between the two groups. The decline in NTG consumption tended to be significant in "mobilizers" compared to controls. Myocardial perfusion was unchanged at adenosine stress single photon emission computerized tomography (SPECT) or magnetic resonance images (MRI). Left ventricular ejection fraction decreased from 57% to 52% (p<0.01, MRI) and from 48% to 44% (p=0.07, SPECT) in G-CSF treated, but was unchanged measured with echocardiography.


CONCLUSIONS
Treatment by G-CSF improved symptoms but not signs of myocardial ischemia in patients with severe IHD. The effects seemed related to mobilization of stem cells. An adverse effect on ejection fraction could not be excluded.
Wang
Yongzhong
Y
Cardiac Catheterization Laboratory, The Heart Centre, Rigshospitalet, Copenhagen, Denmark.
Tägil
Kristina
K
Ripa
Rasmus S
RS
Nilsson
Jens C
JC
Carstensen
Steen
S
Jørgensen
Erik
E
Søndergaard
Lars
L
Hesse
Birger
B
Johnsen
Hans E
HE
Kastrup
Jens
J
D000368:Aged; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000502:physiology*; D019650:Hematopoietic Stem Cell Mobilization; D006412:Hematopoietic Stem Cells / Q000502:physiology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000628:therapy*; D011446:Prospective Studies; D013318:Stroke Volume; D015899:Tomography, Emission-Computed, Single-Photon; D016277:Ventricular Function, Left
D016179:Granulocyte Colony-Stimulating Factor