Bone marrow cells for myocardial repair-a new therapeutic concept.
OBJECTIVE
To assess the safety and feasibility of transfusing autologous bone marrow stem cells (ABMSC) into the culprit coronary artery after an acute anterior wall myocardial infarction (MI) and further to see the ability of ABMSC to promote improvement in Left Ventricular lsqb;LV] function at follow-up.


METHODS
In an ongoing phase I clinical trial, twenty-seven patients of uncomplicated acute anterior wall MI treated as per the current practicing guidelines have been included. Among these, seventeen patients received intra-coronary unfractionated ABMSCs from 77ndash;15 days after acute MI (ABMSC group) and ten patients acted as controls.


RESULTS
All the procedures carried out were without any complications. After 6 months, cardiac function analysis of ten patients from the ABMSC group by LV angiography and Cardiac Magnetic Resonance Imaging (MRI) demonstrated a significant rise of 12.74% (p = 0.001) and 7.1% (p = 0.001), respectively in the LV ejection fraction [LVEF]. There was an improvement in the LV systolic function wherein LV end systolic volume (LVESV) decreased significanty to 28.75% (p = 0.010) and 16.49% (p = 0.022) by LV angiography and cardiac MRI, respectively. LV end diastolic volume (LVEDV) decreased marginally by LV angiography (p = 0.548) and by cardiac MRI (p = 0.514). Five patients of the control group by LV angiography demonstrated non-significant rise of 1.0% (p = 0.706) in LVEF, 12.79% (p = 0.332) in LVEDV and 22.56% (p = 0.308) in LVESV. By cardiac MRI controls demonstrated significant rise in EF of 3.2% (p = 0.0367rpar; but non-significant fall of only 2.32% (p = 0.812) in LVEDV and 6.47% (p 7equals; 0.508) in LVESV.


CONCLUSIONS
This study shows that intracoronary infusion of ABMSC is safe and feasible after acute MI and shows a favourable trend towards the improvement of LV function and prevention of ventricular remodeling which determines long-term survival.
Shah
Vinod K
VK
Sir H. N. Hospital and Research Centre, Raja Rammohan Roy Road, Mumbai 400 004, India. Vkshah45@hotmail.com
Desai
Arvind J
AJ
Vasvani
Jagdish B
JB
Desai
Mukesh M
MM
Shah
Bharat P
BP
Lall
Tilak K
TK
Mashru
Manoj R
MR
Shalia
Kavita K
KK
Tanavde
Vivek
V
Desai
Satish S
SS
Jankharia
Bhavin J
BJ
D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D016026:Bone Marrow Transplantation / Q000379:methods*; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000473:pathology; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000473:pathology / Q000628:therapy*; D012307:Risk Factors; D012449:Safety; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000473:pathology / Q000628:therapy*; D020257:Ventricular Remodeling / Q000502:physiology