title: Percutaneous intramyocardial delivery of mesenchymal stem cells induces superior improvement in regional left ventricular function compared with bone marrow mononuclear cells in porcine myocardial infarcted heart.
abstract: OBJECTIVE
  To investigate the efficacy and feasibility of percutaneous intramyocardial injection of bone marrow mesenchymal stem cells (MSC) and autologous bone marrow-derived mononuclear cells (BMMNC) on cardiac functional improvement in porcine myocardial infarcted hearts.
  
  
  RESULTS
  Acute myocardial infarction (AMI) was induced in 22 minipigs by temporary balloon occlusion of the left anterior descending coronary artery for 60 min.Two weeks post AMI, BMMNC (n = 7, 245 ± 98 × 10(6)), MSC (n = 8, 56 ± 17 × 10(6)), or phosphate buffered saline (PBS; n = 7) were injected intramyocardially. Cardiac function and myocardial perfusion were analyzed by echocardiography and gated single-photon emission computed tomography/computed tomography (SPECT/CT) at 1 week before AMI and 2 and 10 weeks after AMI. Cell engraftment, proliferation, vascular density, and cardiac fibrosis were evaluated by histology analysis. In all groups, the echocardiography revealed no significant change in the left ventricular ejection fraction (LVEF), left ventricular end-systolic volume (LVESV), or left ventricular end-diastolic volume (LVEDV) at 10 weeks after AMI compared with those at 2 weeks after AMI. However, the wall motion score index (WMSI) and left ventricular systolic wall thickening (WT%) were significantly improved at 10 weeks compared with those at 2 weeks after AMI in the MSC group (WMSI 1.55 ± 0.06 vs. 1.87 ± 0.10, WT 33.4 ± 2.3% vs.24.8 ± 2.7%,p < 0.05) but not in the BMMNC group. In addition, myocardial perfusion quantified by SPECT/CT was improved in both the MSC and BMMNC groups, whereas the MSC group showed a superior improvement in vascular density and collagen volume fraction (p < 0.05).
  
  
  CONCLUSIONS
  This preclinically relevant study suggests that when delivered by percutaneous (transcatheter) intramyocardial injection, MSC might be more effective than BMMNC to improve ischemia and reperfusion after AMI.
authors.affiliation: 1. Department of Cardiology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China;
authors.forename: Bo
authors.initials: B
authors.lastname: Tao
authors.affiliation: 1. Department of Cardiology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China;
authors.forename: Mingliang
authors.initials: M
authors.lastname: Cui
authors.affiliation: 1. Department of Cardiology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China;
authors.forename: Chen
authors.initials: C
authors.lastname: Wang
authors.affiliation: 1. Department of Cardiology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China;
authors.forename: Sai
authors.initials: S
authors.lastname: Ma
authors.affiliation: 1. Department of Cardiology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China;
authors.forename: Feng
authors.initials: F
authors.lastname: Wu
authors.affiliation: 1. Department of Cardiology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China;
authors.forename: Fu
authors.initials: F
authors.lastname: Yi
authors.affiliation: 1. Department of Cardiology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China;
authors.forename: Xing
authors.initials: X
authors.lastname: Qin
authors.affiliation: 4. School of Life Science and Technology, Xidian University, Xi'an 710126, China.
authors.forename: Junting
authors.initials: J
authors.lastname: Liu
authors.affiliation: 1. Department of Cardiology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China;
authors.forename: Haichang
authors.initials: H
authors.lastname: Wang
authors.affiliation: 3. Department of Nuclear Medicine,Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China;
authors.forename: Zhe
authors.initials: Z
authors.lastname: Wang
authors.affiliation: 3. Department of Nuclear Medicine,Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China;
authors.forename: Xiaowei
authors.initials: X
authors.lastname: Ma
authors.affiliation: 4. School of Life Science and Technology, Xidian University, Xi'an 710126, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Tian
authors.affiliation: 2. Department of Cardiology, Chinese PLA General Hospital,Beijing 100853, China;
authors.forename: Yundai
authors.initials: Y
authors.lastname: Chen
authors.affiliation: 3. Department of Nuclear Medicine,Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China;
authors.forename: Jing
authors.initials: J
authors.lastname: Wang
authors.affiliation: 2. Department of Cardiology, Chinese PLA General Hospital,Beijing 100853, China;
authors.forename: Feng
authors.initials: F
authors.lastname: Cao
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D004452:Echocardiography; D006321:Heart / Q000502:physiology*; D045164:Mesenchymal Stem Cell Transplantation / Q000379:methods*; D009203:Myocardial Infarction / Q000473:pathology / Q000628:therapy*; D013552:Swine; D013556:Swine, Miniature; D014055:Tomography, Emission-Computed; D016896:Treatment Outcome; D016277:Ventricular Function, Left
keywords: Angiogenesis; Imaging; Myocardial infarction; Remodeling; Stem cells.