title: Transcoronary transplantation of progenitor cells after myocardial infarction.
abstract: BACKGROUND
  Pilot studies suggest that intracoronary transplantation of progenitor cells derived from bone marrow (BMC) or circulating blood (CPC) may improve left ventricular function after acute myocardial infarction. The effects of cell transplantation in patients with healed myocardial infarction are unknown.
  
  
  METHODS
  After an initial pilot trial involving 17 patients, we randomly assigned, in a controlled crossover study, 75 patients with stable ischemic heart disease who had had a myocardial infarction at least 3 months previously to receive either no cell infusion (23 patients) or infusion of CPC (24 patients) or BMC (28 patients) into the patent coronary artery supplying the most dyskinetic left ventricular area. The patients in the control group were subsequently randomly assigned to receive CPC or BMC, and the patients who initially received BMC or CPC crossed over to receive CPC or BMC, respectively, at 3 months' follow-up.
  
  
  RESULTS
  The absolute change in left ventricular ejection fraction was significantly greater among patients receiving BMC (+2.9 percentage points) than among those receiving CPC (-0.4 percentage point, P=0.003) or no infusion (-1.2 percentage points, P<0.001). The increase in global cardiac function was related to significantly enhanced regional contractility in the area targeted by intracoronary infusion of BMC. The crossover phase of the study revealed that intracoronary infusion of BMC was associated with a significant increase in global and regional left ventricular function, regardless of whether patients crossed over from control to BMC or from CPC to BMC.
  
  
  CONCLUSIONS
  Intracoronary infusion of progenitor cells is safe and feasible in patients with healed myocardial infarction. Transplantation of BMC is associated with moderate but significant improvement in the left ventricular ejection fraction after 3 months.
authors.affiliation: Division of Cardiology and Molecular Cardiology, Department of Medicine III, Johann Wolfgang Goethe University, Frankfurt, Germany.
authors.forename: Birgit
authors.initials: B
authors.lastname: Assmus
authors.forename: Jörg
authors.initials: J
authors.lastname: Honold
authors.forename: Volker
authors.initials: V
authors.lastname: Schächinger
authors.forename: Martina B
authors.initials: MB
authors.lastname: Britten
authors.forename: Ulrich
authors.initials: U
authors.lastname: Fischer-Rasokat
authors.forename: Ralf
authors.initials: R
authors.lastname: Lehmann
authors.forename: Claudius
authors.initials: C
authors.lastname: Teupe
authors.forename: Katrin
authors.initials: K
authors.lastname: Pistorius
authors.forename: Hans
authors.initials: H
authors.lastname: Martin
authors.forename: Nasreddin D
authors.initials: ND
authors.lastname: Abolmaali
authors.forename: Torsten
authors.initials: T
authors.lastname: Tonn
authors.forename: Stefanie
authors.initials: S
authors.lastname: Dimmeler
authors.forename: Andreas M
authors.initials: AM
authors.lastname: Zeiher
mesh_terms: D000368:Aged; D016026:Bone Marrow Transplantation / Q000379:methods; D017023:Coronary Angiography; D003331:Coronary Vessels; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology / Q000628:therapy*; D010865:Pilot Projects; D011446:Prospective Studies; D033581:Stem Cell Transplantation / Q000379:methods; D013318:Stroke Volume; D014182:Transplantation, Autologous; D016277:Ventricular Function, Left