title: Intracoronary injection of mononuclear bone marrow cells in acute myocardial infarction.
abstract: BACKGROUND
  Previous studies have shown improvement in left ventricular function after intracoronary injection of autologous cells derived from bone marrow (BMC) in the acute phase of myocardial infarction. We designed a randomized, controlled trial to further investigate the effects of this treatment.
  
  
  METHODS
  Patients with acute ST-elevation myocardial infarction of the anterior wall treated with percutaneous coronary intervention were randomly assigned to the group that underwent intracoronary injection of autologous mononuclear BMC or to the control group, in which neither aspiration nor sham injection was performed. Left ventricular function was assessed with the use of electrocardiogram-gated single-photon-emission computed tomography (SPECT) and echocardiography at baseline and magnetic resonance imaging (MRI) 2 to 3 weeks after the infarction. These procedures were repeated 6 months after the infarction. End points were changes in the left ventricular ejection fraction (LVEF), end-diastolic volume, and infarct size.
  
  
  RESULTS
  Of the 50 patients assigned to treatment with mononuclear BMC, 47 underwent intracoronary injection of the cells at a median of 6 days after myocardial infarction. There were 50 patients in the control group. The mean (+/-SD) change in LVEF, measured with the use of SPECT, between baseline and 6 months after infarction for all patients was 7.6+/-10.4 percentage points. The effect of BMC treatment on the change in LVEF was an increase of 0.6 percentage point (95% confidence interval [CI], -3.4 to 4.6; P=0.77) on SPECT, an increase of 0.6 percentage point (95% CI, -2.6 to 3.8; P=0.70) on echocardiography, and a decrease of 3.0 percentage points (95% CI, 0.1 to -6.1; P=0.054) on MRI. The two groups did not differ significantly in changes in left ventricular end-diastolic volume or infarct size and had similar rates of adverse events.
  
  
  CONCLUSIONS
  With the methods used, we found no effects of intracoronary injection of autologous mononuclear BMC on global left ventricular function.
authors.affiliation: Department of Cardiology, Rikshospitalet University Hospital, Oslo, Norway. ketil.lunde@rikshospitalet.no
authors.forename: Ketil
authors.initials: K
authors.lastname: Lunde
authors.forename: Svein
authors.initials: S
authors.lastname: Solheim
authors.forename: Svend
authors.initials: S
authors.lastname: Aakhus
authors.forename: Harald
authors.initials: H
authors.lastname: Arnesen
authors.forename: Michael
authors.initials: M
authors.lastname: Abdelnoor
authors.forename: Torstein
authors.initials: T
authors.lastname: Egeland
authors.forename: Knut
authors.initials: K
authors.lastname: Endresen
authors.forename: Arnfinn
authors.initials: A
authors.lastname: Ilebekk
authors.forename: Arild
authors.initials: A
authors.lastname: Mangschau
authors.forename: Jan G
authors.initials: JG
authors.lastname: Fjeld
authors.forename: Hans Jørgen
authors.initials: HJ
authors.lastname: Smith
authors.forename: Eli
authors.initials: E
authors.lastname: Taraldsrud
authors.forename: Haakon Kiil
authors.initials: HK
authors.lastname: Grøgaard
authors.forename: Reidar
authors.initials: R
authors.lastname: Bjørnerheim
authors.forename: Magne
authors.initials: M
authors.lastname: Brekke
authors.forename: Carl
authors.initials: C
authors.lastname: Müller
authors.forename: Einar
authors.initials: E
authors.lastname: Hopp
authors.forename: Asgrimur
authors.initials: A
authors.lastname: Ragnarsson
authors.forename: Jan E
authors.initials: JE
authors.lastname: Brinchmann
authors.forename: Kolbjørn
authors.initials: K
authors.lastname: Forfang
mesh_terms: D016026:Bone Marrow Transplantation / Q000009:adverse effects / Q000379:methods; D003331:Coronary Vessels; D003935:Diagnostic Techniques, Cardiovascular; D005260:Female; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology / Q000628:therapy*; D013318:Stroke Volume; D014182:Transplantation, Autologous; D017211:Treatment Failure; D016277:Ventricular Function, Left