Cardiovascular Revascularization Medicine
Volume 7, Issue 4 , Pages 217-221, October 2006

Autologous bone marrow-derived progenitor cell myocardial delivery for recent myocardial infarction patients following early angioplasty: results from a pilot study☆☆☆

  • Maddury Jyotsna

      Affiliations

    • Cardiology Department, Nizam's Institute of Medical Sciences, Hyderabad, India
    • Corresponding Author InformationCorresponding author. Cardiology Department, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Andhra Pradesh, India. Tel.: +91 4027952277; fax: +91 4023310076.
    • ,
  • Geeta K. Vemuganti

      Affiliations

    • Stem Cell Laboratory, LV Prasad Eye Institute, Hyderabad, India
    • ,
  • Purushottam Reddy

      Affiliations

    • Stem Cell Laboratory, LV Prasad Eye Institute, Hyderabad, India
    • ,
  • K. Sarat Chandra

      Affiliations

    • Cardiology Department, Nizam's Institute of Medical Sciences, Hyderabad, India

Received 29 April 2006; accepted 28 June 2006.

Abstract 

Purpose

Cellular cardiomyoplasty is a potential therapeutic approach to preventing left ventricular remodeling after myocardial infarction and has shown encouraging results such as induction of neoangiogenesis and functional improvement of diseased hearts. We report the results of a pilot study on progenitor cells in five patients with acute myocardial infarction (AMI).

Materials and Methods

Patients with single-vessel disease who had their first episode of myocardial infarction and underwent angioplasty after 48 h (an average of 17 days following myocardial infarction) were included in the study. Mononuclear cells (MNCs) (1×107) were isolated by Ficoll Hypaque method from 60 ml of bone marrow (BM) obtained from the iliac crest of 5 patients (aspiration was performed under local anesthesia). The mean CD34 count was 1–4%. After confirming the patency of the affected vessel postangioplasty, cellular concentrate was injected into the affected artery in 3-ml boluses (three to four injections), with intermittent occlusion.

Results

The mean age of all five male patients was 48.6+13.7 years. At 1 year, five patients were asymptomatic, and one had Class II dyspnea on exertion. The results of an echocardiogram performed at 6 months showed an improvement in ejection fraction (EF) from 35.3% to 43.13% and in fractional shortening from 24.75% to 28.33%. End-systolic volume decreased from 115.5 to 92.3 ml, end-diastolic volume decreased from 177.5 to 170 ml, and end-systolic dimensions also decreased from 4.26 to 4 mm, demonstrating positive left ventricular remodeling. Repeat echocardiogram at 1 year showed persistent improvement in EF. No adverse events were noted either before or after the procedure.

Conclusion

The injection of autologous BM MNCs is a safe and efficacious therapy following early revascularization in AMI patients.

Keywords: Mononuclear cells (MNCs), Ejection fraction (EF), Acute myocardial infarction (AMI)

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☆ This work was funded by the Nizam's Institute of Medical Sciences (Hyderabad, India) and the LV Prasad Eye Institute.

☆☆ The authors do not have any commercial interest in any of the materials and methods used in this study.

PII: S1553-8389(06)00183-7

doi:10.1016/j.carrev.2006.06.004

Cardiovascular Revascularization Medicine
Volume 7, Issue 4 , Pages 217-221, October 2006

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