title: Feasibility and safety of intra-coronary bone marrow mononuclear cell transplantation in ST elevation myocardial infarction patients.
abstract: BACKGROUND
  Stem cell transplantation is a potential treatment to improve left ventricular ejection fraction (LVEF) after ST elevation myocardial infarction (STEMI). However technique and mode of transplantation, type of cells, number of cells, and when to transplant are still unknown.
  
  
  OBJECTIVE
  To determine the feasibility and safety of bone marrow mononuclear cell (BMC) intra-coronary transplantation and 6-months results in patients with STEMI.
  
  
  METHODS
  After successful percutaneous coronary intervention (PCI) in STEMI patients who did not have flow re-established within 12 hours and poor LVEF (less than 50%) by echocardiography were enrolled Bone marrow aspiration of 100 cc was performed in the morning. After cell processing for 3 hours, the suspension of BMC about 10 cc were infused to infarcted area using standard PCI technique. Balloon occlusion for 3 minutes was performed during cell infusion. Cardiac magnetic resonance imaging was used to determine LVEF scar volume and LV volume before and 6 months after transplantation.
  
  
  RESULTS
  Five patients were enrolled between May and August 2006. Duration of STEMI before transplantation ranged from 18 days to 14 years. Total amount of BMC ranged from 67 x 10(6) to 335 x 10(6). Number of CD 34 and CD 133+ cells were approximation to be 0.7 x 10(6) to 7.7 x 10(6) and 0.01 x 10(6) to 3.04 x 10(6). LVEF was increased from 36.4 at baseline to 43.3 at 6-month. NT pro-BNP level was decreased from 1105 ng/ml at baseline to 288 pg/ml at 6-month. No complications such as chest pain, no re-flow phenomenon, ventricular arrhythmia, or hypotension was detected during the procedure.
  
  
  CONCLUSIONS
  Intra-coronary BMC transplantation in patients with STEMI in our center is feasible and safe. LVEF was slightly improved; however, a randomized controlled study is needed.
authors.affiliation: Division of Cardiovascular Diseases, Department of Medicine, King Chulalongkorn Memorial Hospital, Bangkok 10330, Thailand. s_srimahachota@yahoo.co.th
authors.forename: Suphot
authors.initials: S
authors.lastname: Srimahachota
authors.forename: Smonporn
authors.initials: S
authors.lastname: Boonyaratavej
authors.forename: Pairoj
authors.initials: P
authors.lastname: Rerkpattanapipat
authors.forename: Somjai
authors.initials: S
authors.lastname: Wangsupachart
authors.forename: Monravee
authors.initials: M
authors.lastname: Tumkosit
authors.forename: Udomsak
authors.initials: U
authors.lastname: Bunworasate
authors.forename: Thayapong Na
authors.initials: TN
authors.lastname: Nakorn
authors.forename: Tanin
authors.initials: T
authors.lastname: Intragumtornchai
authors.forename: Pawinee
authors.initials: P
authors.lastname: Kupatawinturn
authors.forename: Sunisa
authors.initials: S
authors.lastname: Pongam
authors.forename: Aem-orn
authors.initials: AO
authors.lastname: Saengsiri
authors.forename: Mantana
authors.initials: M
authors.lastname: Pothisri
authors.forename: Yeesoon
authors.initials: Y
authors.lastname: Sukseri
authors.forename: Tanorm
authors.initials: T
authors.lastname: Bunprasert
authors.forename: Taworn
authors.initials: T
authors.lastname: Suithichaiyakul
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D016026:Bone Marrow Transplantation / Q000009:adverse effects* / Q000706:statistics & numerical data; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007963:Leukocytes, Mononuclear / Q000637:transplantation; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology / Q000628:therapy*; D020097:Natriuretic Peptide, Brain; D010446:Peptide Fragments; D013318:Stroke Volume; D013785:Thailand; D016277:Ventricular Function, Left
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain