title: Intracoronary autologous bone marrow-derived mononuclear cell transplantation improves coronary collateral vessel formation and recruitment capacity in patients with ischemic cardiomyopathy: a combined hemodynamic and scintigraphic approach.
abstract: This study investigated the effects of intracoronary autologous bone marrow-derived mononuclear cell (BMC) transplantation on coronary microcirculation. Fifteen patients with ischemic cardiomyopathy were treated by intracoronary infusion of BMCs via the patent infarct-related artery. The thermodilution-derived coronary flow reserve, index of microvascular resistance, pressure-derived collateral flow index, and coronary wedge pressure were measured at baseline and at 6 months. Successive balloon inflations during BMC transplantation were performed to observe the recruitment in pressure-derived collateral flow index and coronary wedge pressure, and the percentage changes between baseline and 6 months were calculated. The mean (SD) coronary flow reserve increased from 1.3 (0.4) to 2.1 (0.5), and the mean (SD) index of microvascular resistance decreased from 44.9 (24.4) to 21.2 (14.1) (P = .001 for both). The mean (SD) improvement in pressure-derived collateral flow index (from 0.14 [0.05] to 0.22 [0.08]) was also statistically significant (P = .001). Similarly, the percentage improvements in pressure-derived collateral flow index and coronary wedge pressure were statistically significant (P = .01 for both). The percentage improvement in perfusion assessed by single-photon emission computed tomography strongly correlated with the percentage changes in pressure-derived collateral flow index (r = 0.88, P = .001) and coronary wedge pressure (r = 0.69, P = .01). These results demonstrate for the first time (to our knowledge) that intracoronary autologous BMC transplantation improves coronary collateral vessel formation and recruitment capacity in human subjects.
authors.affiliation: Department of Cardiology, University of Istanbul, Turkey. yeldatayyareci@hotmail.com
authors.forename: Yelda
authors.initials: Y
authors.lastname: Tayyareci
authors.forename: Murat
authors.initials: M
authors.lastname: Sezer
authors.forename: Berrin
authors.initials: B
authors.lastname: Umman
authors.forename: Sevgi
authors.initials: S
authors.lastname: Besisik
authors.forename: Ayse
authors.initials: A
authors.lastname: Mudun
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Sanli
authors.forename: Aytac
authors.initials: A
authors.lastname: Oncul
authors.forename: Nuray
authors.initials: N
authors.lastname: Gurses
authors.forename: Deniz
authors.initials: D
authors.lastname: Sargin
authors.forename: Mehmet
authors.initials: M
authors.lastname: Meric
authors.forename: Yilmaz
authors.initials: Y
authors.lastname: Nisanci
mesh_terms: D001794:Blood Pressure; D016026:Bone Marrow Transplantation; D009202:Cardiomyopathies / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D003097:Collateral Circulation; D003326:Coronary Circulation; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D011446:Prospective Studies; D013318:Stroke Volume; D015899:Tomography, Emission-Computed, Single-Photon; D014182:Transplantation, Autologous