Clinical protocol for angiogenesis by intramyocardial injection of autologous bone marrow mononuclear cells in patients with severe coronary artery disease: TACT-NAGOYA-HEART.
BACKGROUND
Despite recent improvements in the treatments of coronary artery disease (CAD), there are a considerable number of patients who can not receive complete revascularization because of severe or total arterial occlusion. Intramyocardial injection of autologous bone marrow mononuclear cells (ABMMCs) has been shown to induce neovascularization of ischemic myocardium.


RESULTS
The study will investigate the safety and feasibility of intramyocardial injections of ABMMCs and test the hypothesis that this treatment would promote neovascularization and improve left ventricular (LV) global and/or regional function in patients with severe CAD who have no other option. ABMMCs (approximately 10(6) cells) will be injected into the area of ischemic myocardium where the coronary artery is not graftable, in combination with bypass surgery to the other coronary branches. Myocardial perfusion and LV global and regional function will be evaluated, based on the micromanometer-tipped catheter method, single-photon emission tomography, and myocardial enhanced and color tissue Doppler echocardiography at baseline and during 12 month follow-up.


CONCLUSIONS
This project will demonstrate that intramyocardial injection of ABMMCs with or without coronary artery bypass surgery could be a safe and effective method for therapeutic neovascularization, resulting in an improvement of cardiac function in patients with severe CAD.
Izawa
Hideo
H
Department of Cardiology, Nagoya University Graduate School of Medicine, Japan.
Kondo
Takahisa
T
Usui
Akihiko
A
Yamamoto
Koji
K
Shintani
Satoshi
S
Inden
Yasuya
Y
Isobe
Satoshi
S
Unno
Kazumasa
K
Kajiguchi
Masahiro
M
Kato
Tomoko
T
Noda
Akiko
A
Okumura
Kenji
K
Naoe
Tomoki
T
Takamatsu
Junki
J
Komori
Kimihiro
K
Ueda
Yuichi
Y
Murohara
Toyoaki
T
D001854:Bone Marrow Cells; D016026:Bone Marrow Transplantation; D002986:Clinical Trials as Topic; D003324:Coronary Artery Disease / Q000628:therapy*; D006801:Humans; D009206:Myocardium; D018919:Neovascularization, Physiologic; D014182:Transplantation, Autologous