title: Intracoronary transplantation of non-expanded peripheral blood-derived mononuclear cells promotes improvement of cardiac function in patients with acute myocardial infarction.
abstract: 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.
authors.affiliation: Department of Cardiovascular Medicine, Kyoto Prefectural University School of Medicine, Kyoto University Hospital, Japan. tatsumi@koto.kpu-m.ac.jp
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Tatsumi
authors.forename: Eishi
authors.initials: E
authors.lastname: Ashihara
authors.forename: Toshihide
authors.initials: T
authors.lastname: Yasui
authors.forename: Shinsaku
authors.initials: S
authors.lastname: Matsunaga
authors.forename: Atsumichi
authors.initials: A
authors.lastname: Kido
authors.forename: Yuji
authors.initials: Y
authors.lastname: Sasada
authors.forename: Satoshi
authors.initials: S
authors.lastname: Nishikawa
authors.forename: Mitsuyoshi
authors.initials: M
authors.lastname: Hadase
authors.forename: Masahiro
authors.initials: M
authors.lastname: Koide
authors.forename: Reo
authors.initials: R
authors.lastname: Nakamura
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Irie
authors.forename: Kazuki
authors.initials: K
authors.lastname: Ito
authors.forename: Akihiro
authors.initials: A
authors.lastname: Matsui
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Matsui
authors.forename: Maki
authors.initials: M
authors.lastname: Katamura
authors.forename: Shigehiro
authors.initials: S
authors.lastname: Kusuoka
authors.forename: Satoaki
authors.initials: S
authors.lastname: Matoba
authors.forename: Satoshi
authors.initials: S
authors.lastname: Okayama
authors.forename: Manabu
authors.initials: M
authors.lastname: Horii
authors.forename: Shiro
authors.initials: S
authors.lastname: Uemura
authors.forename: Chihiro
authors.initials: C
authors.lastname: Shimazaki
authors.forename: Hajime
authors.initials: H
authors.lastname: Tsuji
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Saito
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Matsubara
mesh_terms: 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