[The autologous bone marrow mononuclear cell transplantation by intracoronary route treat patients with severe heart failure after myocardial infarction].
OBJECTIVE
To investigate the chronic effects of intracoronary autologous bone marrow mononuclear cell (BM-MNCs) transplantation in patients with refractory heart failure (RIHF) after myocardial infarction.


METHODS
Thirty patients with RIHF (LVEF < 40%) were enrolled in this nonrandomized study, autologous BM-MNCs (5.0 +/- 0.7) x 10(7) were transplanted with via infarct-related coronary artery in 16 patients and 14 patients received standard medical therapy served as control. Baseline and follow up evaluations included complete clinical evaluations, plasma BNP, ANP, ET-1 measurements, echocardiography, PET, and Holter monitoring.


RESULTS
Baseline characteristics were similar between the 2 groups. There were no major periprocedural complications. One patient developed ventricular premature contractions during cell infusion for several seconds and recovered spontaneously. Compared to pre-transplantation, plasma BNP and ET-1 significantly decreased and plasma ANP significantly increased at 7 days post transplantation; 6 minutes walking distance increased from (72.1 +/- 31.5) to (201.6 +/- 23.3) m (P < 0.01), LVEF increased 9.9% (P < 0.001) and FDG-PET revealed vital myocardium area increased (10.3 +/- 3.4)% (P < 0.01) at 3 months after BM-MNCs transplantation. At 6 months follow up, the NYHA class improved from (3.4 +/- 0.1 to 2.4 +/- 0.2, P < 0.001) and no patient died and 1 patient rehospitalized due to lower extremities edema. In control group, LVEF decreased 7.2% compared to baseline (P < 0.001) and was significantly lower than transplantation group at 3 months (P < 0.001). At 6 months follow up, the NYHA class increased from (3.5 +/- 0.1 to 3.9 +/- 0.1, P < 0.05), 2 patients died and 10 patients rehospitalized due to aggravated heart failure.


CONCLUSIONS
Present study demonstrates that intracoronary transplantation of autologous BM-MNCs is safe and effective for treating patients with RIHF after myocardial infarction.
Gao
Lian-ru
LR
Department of Cardiology, Navy General Hospital, Beijing 100037, China. lianru@yahoo.com.cn
Tang
Chao-shu
CS
Zhu
Zhi-ming
ZM
Wang
Zhi-guo
ZG
Fei
Yu-xing
YX
Tian
Hai-tao
HT
Zhu
Jia-rui
JR
He
Sheng
S
Ding
Qing-ai
QA
Yang
Ye
Y
D016026:Bone Marrow Transplantation; D003331:Coronary Vessels / Q000601:surgery; D005500:Follow-Up Studies; D006333:Heart Failure / Q000150:complications; D006801:Humans; D045164:Mesenchymal Stem Cell Transplantation; D009000:Monocytes / Q000637:transplantation; D009203:Myocardial Infarction / Q000601:surgery*; D017202:Myocardial Ischemia / Q000150:complications*; D014182:Transplantation, Autologous