title: Endomyocardial implantation of autologous bone marrow mononuclear cells in advanced ischemic heart failure: a randomized placebo-controlled trial (END-HF).
abstract: Prior studies suggest that endomyocardial implantation of autologous bone marrow (BM) mononuclear cell therapy improves symptoms and left ventricular (LV) function in patients with refractory angina; however, the therapeutic efficacy in patients with ischemic cardiomyopathy is unclear. In a randomized, double-blind, placebo-controlled trial, 28 patients with advanced ischemic cardiomyopathy [New York Heart Association III-IV, LV ejection fraction (LVEF) <40 %] were assigned in 2:1 ratio to receive endomyocardial injection of BM cells (100 million, n = 19) or placebo (n = 9), guided by electroanatomical mapping. After 6 months, there was no significant difference between the two groups in LV ejection fraction (LVEF) and LV end-systolic volume (LVESV), LV infarct volume, and LV peri-infarct ischemic volume as determined by cardiac magnetic resonance imaging or exercise capacity. In conclusion, endomyocardial implantation of autologous BM mononuclear cells did not improve LV function or remodeling in patients with advanced ischemic cardiomyopathy.
authors: Department of Internal Medicine, Faculty of Medicine, Dr. Cipto Mangunkusumo Hospital, University of Indonesia, Jakarta, Indonesia.
authors: Teguh
authors: T
authors: Santoso
authors: Ching-Wah
authors: CW
authors: Siu
authors: Cosphiadi
authors: C
authors: Irawan
authors: Wing-Sze
authors: WS
authors: Chan
authors: Idrus
authors: I
authors: Alwi
authors: Kai-Hang
authors: KH
authors: Yiu
authors: Auda
authors: A
authors: Aziz
authors: Yok-Lam
authors: YL
authors: Kwong
authors: Hung-Fat
authors: HF
authors: Tse
mesh_terms: D064592:Autografts; D016026:Bone Marrow Transplantation / Q000379:methods*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007267:Injections; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D009206:Myocardium; D012189:Retrospective Studies; D013318:Stroke Volume; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000502:physiology*; D020257:Ventricular Remodeling / Q000502:physiology*