Intracoronary injection of CD133-positive enriched bone marrow progenitor cells promotes cardiac recovery after recent myocardial infarction: feasibility and safety.
BACKGROUND
Bone marrow CD133-positive (CD133+) cells possess high hematopoietic and angiogenic capacity. We tested the feasibility, safety, and functional effects of the use of enriched CD133+ progenitor cells after intracoronary administration in patients with recent myocardial infarction.


RESULTS
Among 35 patients with acute myocardial infarction treated with stenting, 19 underwent intracoronary administration of CD133+ progenitor cells (12.6+/-2.2 x 10(6) cells) 11.6+/-1.4 days later (group 1) and 16 did not (group 2). At 4 months, left ventricular ejection fraction increased significantly in group 1 (from 45.0+/-2.6% to 52.1+/-3.5%, P<0.05), but only tended to increase in case-matched group 2 patients (from 44.3+/-3.1% to 48.6+/-3.6%, P=NS). Likewise, left ventricular regional chordae shortening increased in group 1 (from 11.5+/-1.0% to 16.1+/-1.3%, P<0.05) but remained unchanged in group 2 patients (from 11.1+/-1.1% to 12.7+/-1.3%, P=NS). This was paralleled by reduction in the perfusion defect in group 1 (from 28.0+/-4.1% to 22.5+/-4.1%, P<0.05) and no change in group 2 (from 25.0+/-3.0% to 22.6+/-4.1%, P=NS). In group 1, two patients developed in-stent reocclusion, 7 developed in-stent restenosis, and 2 developed significant de novo lesion of the infarct-related artery. In group 2, four patients showed in-stent restenosis. In group 1 patients without reocclusion, glucose uptake shown by positron emission tomography with 18fluorodeoxyglucose in the infarct-related territory increased from 51.2+/-2.6% to 57.5+/-3.5% (P<0.05). No stem cell-related arrhythmias were noted, either clinically or during programmed stimulation studies at 4 months.


CONCLUSIONS
In patients with recent myocardial infarction, intracoronary administration of enriched CD133+ cells is feasible but was associated with increased incidence of coronary events. Nevertheless, it seems to be associated with improved left ventricular performance paralleled with increased myocardial perfusion and viability.
Bartunek
Jozef
J
Cardiovascular Center, OLV Ziekenhuis, Aalst, Belgium. Jozef.Bartunek@olvz-aalst.be
Vanderheyden
Marc
M
Vandekerckhove
Bart
B
Mansour
Samer
S
De Bruyne
Bernard
B
De Bondt
Pieter
P
Van Haute
Inge
I
Lootens
Nele
N
Heyndrickx
Guy
G
Wijns
William
W
D000071916:AC133 Antigen; D015703:Antigens, CD / Q000032:analysis; D016022:Case-Control Studies; D002815:Chordae Tendineae / Q000000981:diagnostic imaging / Q000503:physiopathology; D003326:Coronary Circulation; D023903:Coronary Restenosis / Q000453:epidemiology; D003331:Coronary Vessels; D005240:Feasibility Studies; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006023:Glycoproteins / Q000032:analysis; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007269:Injections, Intra-Arterial; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D010455:Peptides / Q000032:analysis; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D015607:Stents; D013318:Stroke Volume; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon; D016896:Treatment Outcome; D014463:Ultrasonography; D016277:Ventricular Function, Left
D000071916:AC133 Antigen; D015703:Antigens, CD; D006023:Glycoproteins; C000606023:PROM1 protein, human; D010455:Peptides; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D017256:Technetium Tc 99m Sestamibi