Randomized study of mononuclear bone marrow cell transplantation in patients with coronary surgery.
BACKGROUND
Mononuclear bone marrow cell (MN-BMC) transplantation has great clinical potential to promote myocardiogenesis and angiogenesis. This randomized study was designed to assess the feasibility and safety of MN-BMC transplantation during coronary artery bypass grafting (CABG) in patients with ischemic heart failure.


METHODS
Thirty-six patients were prospectively enrolled and randomized to a MN-BMC group (n = 18) and a control group (n = 18). A mean number of 6.59 x 10(8) +/- 5.12 x 10(8) MN-BMC were injected into the infarcted and marginal areas during CABG in the MN-BMC group. The patients in the control group underwent CABG alone. All patients were followed up to 6 months.


RESULTS
There was one death in the MN-BMC group and no death in the control group. Two patients developed ventricular arrhythmia in the MN-BMC group. Compared with baseline and the control group, therapeutic effects of MN-BMC transplantation were observed over time. Heart function (New York Heart Association) was significantly improved and angina pectoris was alleviated in the MN-BMC group. Left ventricular ejection fraction in the MN-BMC group was greater than the control group. The thickness and motion velocity of the infarcted wall were significantly increased in the MN-BMC group. More pronounced perfusion improvements of ischemic regions and LV were observed in the MN-BMC group. There was one late death in the MN-BMC group. No procedure-related complications occurred.


CONCLUSIONS
MN-BMC transplantation improves cardiac function and regional perfusion in ischemic heart failure patients during CABG. A large cohort with long-term follow-up is needed to further evaluate the safety of MN-BMC transplantation.
Zhao
Qiang
Q
Department of Cardiac Surgery, Zhongshan Hospital Fudan University, Shanghai, China.
Sun
Yongxin
Y
Xia
Limin
L
Chen
Anqing
A
Wang
Zhe
Z
D000368:Aged; D016026:Bone Marrow Transplantation / Q000379:methods* / Q000401:mortality; D003131:Combined Modality Therapy; D017023:Coronary Angiography / Q000379:methods; D001026:Coronary Artery Bypass / Q000379:methods* / Q000401:mortality; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D006321:Heart / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D018919:Neovascularization, Physiologic / Q000502:physiology; D011183:Postoperative Complications / Q000401:mortality; D011336:Probability; D011446:Prospective Studies; D012016:Reference Values; D012038:Regeneration / Q000502:physiology*; D018570:Risk Assessment; D012720:Severity of Illness Index; D016019:Survival Analysis; D015899:Tomography, Emission-Computed, Single-Photon; D014182:Transplantation, Autologous; D016896:Treatment Outcome