Intracoronary transplantation of non-expanded peripheral blood-derived mononuclear cells promotes improvement of cardiac function in patients with acute myocardial infarction.
BACKGROUND
Transplantation of non-expanded peripheral blood mononuclear cells (PBMNCs) enhances neovessel formation in ischemic myocardium and limbs by releasing angiogenic factors. This study was designed to examine whether intracoronary transplantation of PBMNCs improves cardiac function after acute myocardial infarction (AMI).


RESULTS
After successful percutaneous coronary intervention (PCI) for a ST-elevation AMI with occlusion of proximal left anterior descending coronary artery within 24 h, patients received an intracoronary infusion of PBMNCs within 5 days after PCI (PBMNC group). PBMNCs were obtained from patients by COBE spectra-apheresis and concentrated to 10 ml, 3.3 ml of which was infused via over-the-wire catheter. The global left ventricular ejection fraction (LVEF) change from baseline to 6 months followup in th ePBMNC group that underwent standard PCI for similar AMI [corrected]. The primary endpoint was the global left ventricular ejection fraction (LVEF) change from baseline to 6 months' follow-up. The data showed that the absolute increase in LVEF was 7.4% in the control group and 13.4% (p=0.037 vs control) in the PBMNC group. Cell therapy resulted in a greater tendency of DeltaRegional ejection fraction (EF) or significant improvement in the wall motion score index and Tc-99m-tetrofosmin perfusion defect score associated with the infarct area, compared with controls. Moreover, intracoronary administration of PBMNCs did not exacerbate either left ventricular (LV) end-diastolic and end-systolic volume expansion or high-risk arrhythmia, without any adverse clinical events.


CONCLUSIONS
Intracoronary infusion of non-expanded PBMNCs promotes improvement of LV systolic function. This less invasive and more feasible approach to collecting endothelial progenitor cells may provide a novel therapeutic option for improving cardiac function after AMI.
Tatsumi
Tetsuya
T
Department of Cardiovascular Medicine, Kyoto Prefectural University School of Medicine, Kyoto University Hospital, Japan. tatsumi@koto.kpu-m.ac.jp
Ashihara
Eishi
E
Yasui
Toshihide
T
Matsunaga
Shinsaku
S
Kido
Atsumichi
A
Sasada
Yuji
Y
Nishikawa
Satoshi
S
Hadase
Mitsuyoshi
M
Koide
Masahiro
M
Nakamura
Reo
R
Irie
Hidekazu
H
Ito
Kazuki
K
Matsui
Akihiro
A
Matsui
Hiroyuki
H
Katamura
Maki
M
Kusuoka
Shigehiro
S
Matoba
Satoaki
S
Okayama
Satoshi
S
Horii
Manabu
M
Uemura
Shiro
S
Shimazaki
Chihiro
C
Tsuji
Hajime
H
Saito
Yoshihiko
Y
Matsubara
Hiroaki
H
D000368:Aged; D004562:Electrocardiography; D005260:Female; D006334:Heart Function Tests; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods; D013318:Stroke Volume; D014184:Transplantation, Homologous; D016896:Treatment Outcome