title: Effects of Intracoronary Infusion of Escalating Doses of Cardiac Stem Cells in Rats With Acute Myocardial Infarction.
abstract: BACKGROUND
  Although c-kit(pos) cardiac stem cells (CSCs) preserve left ventricular (LV) function and structure after myocardial infarction, CSC doses have been chosen arbitrarily, and the dose-effect relationship is unknown.
  
  
  RESULTS
  Rats underwent a 90-minute coronary occlusion followed by 35 days of reperfusion. Vehicle or CSCs at 5 escalating doses (0.3×10(6), 0.75×10(6), 1.5×10(6), 3.0×10(6), and 6.0×10(6) cells/heart) were given intracoronarily 4 h after reperfusion. The lowest dose (0.3×10(6)) had no effect on LV function and morphology, whereas 0.75, 1.5, and 3.0×10(6) significantly improved regional and global LV function (echocardiography and hemodynamic studies). These 3 doses had similar effects on echocardiographic parameters (infarct wall thickening fraction, LV end-systolic and end-diastolic volumes, LV ejection fraction) and hemodynamic variables (LV end-diastolic pressure, LV dP/dtmax, preload adjusted maximal power, end-systolic elastance, preload recruitable stroke work) and produced similar reductions in apoptosis, scar size, infarct wall thinning, and LV expansion index and similar increases in viable myocardium in the risk region (morphometry). Infusion of 6.0×10(6) CSCs markedly increased postprocedural mortality. Green fluorescent protein and 5-bromo-2'-deoxyuridine staining indicated that persistence of donor cells and formation of new myocytes were negligible with all doses.
  
  
  CONCLUSIONS
  Surprisingly, in this rat model of acute myocardial infarction, the dose-response relationship for intracoronary CSCs is flat. A minimal dose between 0.3 and 0.75×10(6) is necessary for efficacy; above this threshold, a 4-fold increase in cell number does not produce greater improvement in LV function or structure. Further increases in cell dose are harmful.
authors.affiliation: From the Division of Cardiovascular Medicine and Institute of Molecular Cardiology, University of Louisville, KY (X.-L.T., G.R., S.K.S., Y.T., M.C.L.K., G.S., H.S., G.N.H., W.W., R.B.); and Division of Cardiovascular Diseases and the Cardiovascular Research Institute, University of Kansas Medical Center, Kansas City (B.D.).
authors.forename: Xian-Liang
authors.initials: XL
authors.lastname: Tang
authors.affiliation: From the Division of Cardiovascular Medicine and Institute of Molecular Cardiology, University of Louisville, KY (X.-L.T., G.R., S.K.S., Y.T., M.C.L.K., G.S., H.S., G.N.H., W.W., R.B.); and Division of Cardiovascular Diseases and the Cardiovascular Research Institute, University of Kansas Medical Center, Kansas City (B.D.).
authors.forename: Gregg
authors.initials: G
authors.lastname: Rokosh
authors.affiliation: From the Division of Cardiovascular Medicine and Institute of Molecular Cardiology, University of Louisville, KY (X.-L.T., G.R., S.K.S., Y.T., M.C.L.K., G.S., H.S., G.N.H., W.W., R.B.); and Division of Cardiovascular Diseases and the Cardiovascular Research Institute, University of Kansas Medical Center, Kansas City (B.D.).
authors.forename: Santosh K
authors.initials: SK
authors.lastname: Sanganalmath
authors.affiliation: From the Division of Cardiovascular Medicine and Institute of Molecular Cardiology, University of Louisville, KY (X.-L.T., G.R., S.K.S., Y.T., M.C.L.K., G.S., H.S., G.N.H., W.W., R.B.); and Division of Cardiovascular Diseases and the Cardiovascular Research Institute, University of Kansas Medical Center, Kansas City (B.D.).
authors.forename: Yukichi
authors.initials: Y
authors.lastname: Tokita
authors.affiliation: From the Division of Cardiovascular Medicine and Institute of Molecular Cardiology, University of Louisville, KY (X.-L.T., G.R., S.K.S., Y.T., M.C.L.K., G.S., H.S., G.N.H., W.W., R.B.); and Division of Cardiovascular Diseases and the Cardiovascular Research Institute, University of Kansas Medical Center, Kansas City (B.D.).
authors.forename: Matthew C L
authors.initials: MC
authors.lastname: Keith
authors.affiliation: From the Division of Cardiovascular Medicine and Institute of Molecular Cardiology, University of Louisville, KY (X.-L.T., G.R., S.K.S., Y.T., M.C.L.K., G.S., H.S., G.N.H., W.W., R.B.); and Division of Cardiovascular Diseases and the Cardiovascular Research Institute, University of Kansas Medical Center, Kansas City (B.D.).
authors.forename: Gregg
authors.initials: G
authors.lastname: Shirk
authors.affiliation: From the Division of Cardiovascular Medicine and Institute of Molecular Cardiology, University of Louisville, KY (X.-L.T., G.R., S.K.S., Y.T., M.C.L.K., G.S., H.S., G.N.H., W.W., R.B.); and Division of Cardiovascular Diseases and the Cardiovascular Research Institute, University of Kansas Medical Center, Kansas City (B.D.).
authors.forename: Heather
authors.initials: H
authors.lastname: Stowers
authors.affiliation: From the Division of Cardiovascular Medicine and Institute of Molecular Cardiology, University of Louisville, KY (X.-L.T., G.R., S.K.S., Y.T., M.C.L.K., G.S., H.S., G.N.H., W.W., R.B.); and Division of Cardiovascular Diseases and the Cardiovascular Research Institute, University of Kansas Medical Center, Kansas City (B.D.).
authors.forename: Gregory N
authors.initials: GN
authors.lastname: Hunt
authors.affiliation: From the Division of Cardiovascular Medicine and Institute of Molecular Cardiology, University of Louisville, KY (X.-L.T., G.R., S.K.S., Y.T., M.C.L.K., G.S., H.S., G.N.H., W.W., R.B.); and Division of Cardiovascular Diseases and the Cardiovascular Research Institute, University of Kansas Medical Center, Kansas City (B.D.).
authors.forename: Wenjian
authors.initials: W
authors.lastname: Wu
authors.affiliation: From the Division of Cardiovascular Medicine and Institute of Molecular Cardiology, University of Louisville, KY (X.-L.T., G.R., S.K.S., Y.T., M.C.L.K., G.S., H.S., G.N.H., W.W., R.B.); and Division of Cardiovascular Diseases and the Cardiovascular Research Institute, University of Kansas Medical Center, Kansas City (B.D.).
authors.forename: Buddhadeb
authors.initials: B
authors.lastname: Dawn
authors.affiliation: From the Division of Cardiovascular Medicine and Institute of Molecular Cardiology, University of Louisville, KY (X.-L.T., G.R., S.K.S., Y.T., M.C.L.K., G.S., H.S., G.N.H., W.W., R.B.); and Division of Cardiovascular Diseases and the Cardiovascular Research Institute, University of Kansas Medical Center, Kansas City (B.D.). rbolli@louisville.edu.
authors.forename: Roberto
authors.initials: R
authors.lastname: Bolli
mesh_terms: D000818:Animals; D017209:Apoptosis; D015415:Biomarkers / Q000378:metabolism; D002196:Capillaries / Q000503:physiopathology; D002302:Cardiac Output; D002454:Cell Differentiation; D049109:Cell Proliferation; D002478:Cells, Cultured; D004195:Disease Models, Animal; D008297:Male; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D009206:Myocardium / Q000378:metabolism / Q000473:pathology*; D032383:Myocytes, Cardiac / Q000378:metabolism / Q000473:pathology / Q000637:transplantation*; D018919:Neovascularization, Physiologic; D019009:Proto-Oncogene Proteins c-kit / Q000378:metabolism; D011916:Rats, Inbred F344; D020127:Recovery of Function; D012038:Regeneration; D033581:Stem Cell Transplantation / Q000009:adverse effects; D013234:Stem Cells / Q000378:metabolism; D013997:Time Factors; D014022:Tissue Survival; D014463:Ultrasonography; D016277:Ventricular Function, Left; D017725:Ventricular Pressure
chemical_list: D015415:Biomarkers; D019009:Proto-Oncogene Proteins c-kit
keywords: left ventricular function; myocardial infarction; myocardial ischemia; myocardial regeneration; progenitor cells