title: [Cardiomyoplasty with autological mononuclear cells of the bone marrow in patients with acute myocardial infarction].
abstract: OBJECTIVE
  To study efficacy and safety of transplantation of bone marrow autologous mononuclear cells (BMAMC) in patients with acute myocardial infarction; to examine BMAMC distribution in the human body after intracoronary introduction.
  
  
  METHODS
  The open controlled trial investigated 26 AMI patients (16 entered the study group and 10 were controls). Cell cardiomyoplasty with BMAMC was performed by intracoronary injection of the cells after stenting the coronary artery supplying blood to the infarction zone on AMI day 7-21. BMAMC were isolated by gradient centrifugation. Distribution of mononuclear cells was studied with radionuclear indication of the cells 99m-Tc-HMPAO. All the patients were examined with Tl-199 perfusion scintigraphy of the heart 2 weeks and 6 months after the treatment, echocardiography, 24-h ECG monitoring, 6-min walk test.
  
  
  RESULTS
  All the patients were followed up for 6 months. Two patients (one in each group) developed recurrent myocardial infarction 3 months after the first. Radionuclide investigations revealed fixation of labelled mononuclear cells in the heart both in initial hours after the treatment and 24 hours after it. As shown by myocardial scintigraphy, intracoronary administration of the cells with short-term arterial occlusion was followed by much greater number of labeled cells. By follow-up month 6, in the study group, left ventricular ejection fraction increased more: 12.7 +/- 3.2% versus 10.4 +/- 2.5% in the control group (p = 0.09); moreover, a stable defect of myocardial perfusion reduced more (by 29 +/- 24% against 20 +/- 18%, respectively, p = 0.1). Malignant arrhythmia, complications during and after bone marrow aspiration, intracoronary administration of cell suspension were not registered.
  
  
  CONCLUSIONS
  Intracoronary administration of BMAMC in AMI patients is safe and provides their transfer and fixation in the myocardium. BMAMC transplantation has a positive effect on recovery of perfusion and contractile function of left ventricular myocardium in AMI patients.
authors.forename: V V
authors.initials: VV
authors.lastname: Riabov
authors.forename: T E
authors.initials: TE
authors.lastname: Suslova
authors.forename: A L
authors.initials: AL
authors.lastname: Krylov
authors.forename: Iu S
authors.initials: IuS
authors.lastname: Poponina
authors.forename: Zh V
authors.initials: ZhV
authors.lastname: Vesnina
authors.forename: S I
authors.initials: SI
authors.lastname: Sazonova
authors.forename: V A
authors.initials: VA
authors.lastname: Markov
authors.forename: S V
authors.initials: SV
authors.lastname: Popov
authors.forename: R S
authors.initials: RS
authors.lastname: Karpov
mesh_terms: D001854:Bone Marrow Cells / Q000166:cytology*; D016026:Bone Marrow Transplantation; D018421:Cardiomyoplasty / Q000379:methods*; D017023:Coronary Angiography; D003331:Coronary Vessels; D004452:Echocardiography; D015716:Electrocardiography, Ambulatory; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007269:Injections, Intra-Arterial; D007963:Leukocytes, Mononuclear / Q000166:cytology / Q000637:transplantation*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D014182:Transplantation, Autologous; D016896:Treatment Outcome