title: Intracoronary infusion of autologous mononuclear bone marrow cells in patients with acute myocardial infarction treated with primary PCI: Pilot study of the multicenter HEBE trial.
abstract: OBJECTIVE
  This study was a pilot trial to determine safety and feasibility of intracoronary infusion of mononuclear bone marrow cells (MBMC) in patients with acute myocardial infarction (MI).
  
  
  BACKGROUND
  Studies reporting the effect of MBMC therapy on improvement of left ventricular (LV) function have shown variable results. The HEBE trial is a large multicenter, randomized trial that currently enrolls patients. Prior to this trial we performed a pilot study.
  
  
  METHODS
  Twenty-six patients with a first acute MI were prospectively enrolled in eight centers. Bone marrow aspiration was performed at a median of 6 days after primary PCI (interquartile range, 5-7 days). MBMC were isolated by gradient centrifugation and were infused intracoronary the same day. All patients underwent magnetic resonance imaging before cell infusion and after 4 months. Clinical events were assessed up to 12 months.
  
  
  RESULTS
  Within 10 hr after bone marrow aspiration, 246 +/- 133 x 10(6) MBMC were infused, of which 3.9 +/- 2.3 x 10(6) cells were CD34(+). In one patient, this procedure was complicated by local dissection. LV ejection fraction significantly increased from 45.0 +/- 6.3% to 47.2 +/- 6.5% (P = 0.03). Systolic wall thickening in dysfunctional segments at baseline improved with 0.9 +/- 0.7 mm (P < 0.001). Infarct size decreased 37% from 17.8 +/- 8.2 to 11.2 +/- 4.2 gram (P < 0.001). During 12-month follow-up, 3 additional revascularizations were performed and an ICD was implanted in one patient, 3 weeks after PCI.
  
  
  CONCLUSIONS
  In patients with acute MI, intracoronary infusion of MBMC is safe in a multicenter setting. At 4-month follow-up, a modest increase in global and regional LV function was observed, with a concomitant decrease in infarct size.
authors.affiliation: Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Alexander
authors.initials: A
authors.lastname: Hirsch
authors.forename: Robin
authors.initials: R
authors.lastname: Nijveldt
authors.forename: Pieter A
authors.initials: PA
authors.lastname: van der Vleuten
authors.forename: René A
authors.initials: RA
authors.lastname: Tio
authors.forename: Willem J
authors.initials: WJ
authors.lastname: van der Giessen
authors.forename: Koen M J
authors.initials: KM
authors.lastname: Marques
authors.forename: Pieter A
authors.initials: PA
authors.lastname: Doevendans
authors.forename: Johannes
authors.initials: J
authors.lastname: Waltenberger
authors.forename: Jurrien M
authors.initials: JM
authors.lastname: Ten Berg
authors.forename: Wim R M
authors.initials: WR
authors.lastname: Aengevaeren
authors.forename: Bart J
authors.initials: BJ
authors.lastname: Biemond
authors.forename: Jan G P
authors.initials: JG
authors.lastname: Tijssen
authors.forename: Albert C
authors.initials: AC
authors.lastname: van Rossum
authors.forename: Jan J
authors.initials: JJ
authors.lastname: Piek
authors.forename: Felix
authors.initials: F
authors.lastname: Zijlstra
mesh_terms: D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D016026:Bone Marrow Transplantation / Q000379:methods*; D003131:Combined Modality Therapy; D003331:Coronary Vessels; D015150:Echocardiography, Doppler; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D036502:Infusions, Intralesional; D016014:Linear Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D010865:Pilot Projects; D011336:Probability; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016019:Survival Analysis; D020858:Tissue and Organ Harvesting; D014182:Transplantation, Autologous; D016896:Treatment Outcome