title: Autologous bone-marrow mononuclear cell transplantation after acute myocardial infarction: comparison of two delivery techniques.
abstract: The objective of this study was to investigate safety and feasibility of autologous bone marrow mononuclear cells (BMMNC) transplantation in ST elevation myocardial infarction (STEMI), comparing anterograde intracoronary artery (ICA) delivery with retrograde intracoronary vein (ICV) approach. An open labeled, randomized controlled trial of 30 patients admitted with STEMI was used. Patients were enrolled if they 1) were successfully reperfused within 24 h from symptoms onset and 2) had infarct size larger than 10% of the left ventricle (LV). One hundred million BMMNC were injected in the infarct-related artery (intra-arterial group) or vein (intravenous group), 1% of which was labeled with Tc(99m)-hexamethylpropylenamineoxime. Cell distribution was evaluated 4 and 24 h after injection. Baseline MRI was performed in order to evaluate microbstruction pattern. Baseline radionuclide ventriculography was performed before cell transfer and after 3 and 6 months. All the treated patients were submitted to repeat coronary angiography after 3 months. Thirty patients (57 +/- 11 years, 70% males) were randomly assigned to ICA (n = 14), ICV (n = 10), or control (n = 6) groups. No serious adverse events related to the procedure were observed. Early and late retention of radiolabeled cells was higher in the ICA than in the ICV group, independently of microcirculation obstruction. An increase of EF was observed in the ICA group (p = 0.02) compared to baseline. Injection procedures through anterograde and retrograde approaches seem to be feasible and safe. BMMNC retention by damaged heart tissue was apparently higher when the anterograde approach was used. Further studies are required to confirm these initial data.
authors: Teaching and Research Center of Pró-Cardíaco/PROCEP, Rio de Janeiro, Brazil.
authors: Suzana A
authors: SA
authors: Silva
authors: André L S
authors: AL
authors: Sousa
authors: Andrea F
authors: AF
authors: Haddad
authors: Jader C
authors: JC
authors: Azevedo
authors: Vinicio E
authors: VE
authors: Soares
authors: Cíntia M
authors: CM
authors: Peixoto
authors: Ana J S
authors: AJ
authors: Soares
authors: Aurora F C
authors: AF
authors: Issa
authors: Luis Renato V
authors: LR
authors: Felipe
authors: Rodrigo V C
authors: RV
authors: Branco
authors: João A
authors: JA
authors: Addad
authors: Rodrigo C
authors: RC
authors: Moreira
authors: Fabio A A
authors: FA
authors: Tuche
authors: Cláudio T
authors: CT
authors: Mesquita
authors: Cristina C O
authors: CC
authors: Drumond
authors: Amarino O
authors: AO
authors: Junior
authors: Carlos E
authors: CE
authors: Rochitte
authors: José H M
authors: JH
authors: Luz
authors: Arnaldo
authors: A
authors: Rabischoffisky
authors: Fernanda B
authors: FB
authors: Nogueira
authors: Rosana B C
authors: RB
authors: Vieira
authors: Hamilton S
authors: HS
authors: Junior
authors: Radovan
authors: R
authors: Borojevic
authors: Hans F R
authors: HF
authors: Dohmann
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016026:Bone Marrow Transplantation / Q000379:methods*; D003710:Demography; D005260:Female; D006801:Humans; D007267:Injections; D007963:Leukocytes, Mononuclear / Q000637:transplantation*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D009566:Nitrates; D015635:Radionuclide Ventriculography; D019690:Technetium Tc 99m Exametazime; D017256:Technetium Tc 99m Sestamibi; D014182:Transplantation, Autologous
chemical_list: D009566:Nitrates; D019690:Technetium Tc 99m Exametazime; D017256:Technetium Tc 99m Sestamibi