Document Detail


Efficiency of intramyocardial injections of autologous bone marrow mononuclear cells in patients with ischemic heart failure: a randomized study.
MedLine Citation:
PMID:  20560030     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Intramyocardial transplantation of autologous bone marrow mononuclear cells (BMMC) is believed to be a promising method for the treatment of patients with chronic ischemic heart disease. The aim of this study was to evaluate long-term results of intramyocardial bone marrow cell transplantation in patients with severe ischemic heart failure. One hundred nine patients with chronic myocardial infarction and end-stage chronic heart failure were randomized into two groups: 55 patients received intramyocardial BMMC injection and 54 received optimal medical therapy. The NOGA system (Biosense-Webster) was used to administer 41 +/- 16 x 106 BMMC into the border zone of myocardial infarction. None of the patients developed periprocedural complications following BMMC injections. The injections led to improvement of CCS class (3.1 +/- 0.4 to 1.6 +/- 0.6 after 6 months and 1.6 +/- 0.4 after 12 months; p = 0.001) and NYHA functional class (3.3 +/- 0.2 to 2.3 +/- 0.2 after 6 months and 2.5 +/- 0.1 after 12 months; p = 0.006). Left ventricular ejection fraction increased significantly in the BMMC group (27.8 +/- 3.4% vs 32.3 +/- 4.1%; p = 0.04) while it tended to decrease in the control group (26.8 +/- 3.8% to 25.2 +/- 4.1%; p = 0.61). Summed rest score improved in the BMMC group after 12 months (30.2 +/- 5.6 to 27.8 +/- 5.1; p = 0.032). The improvement of stress score was more noticeable (34.5 +/- 5.4 to 28.1 +/- 5.2; p = 0.016). Neither stress nor rest score changed in patients numbers on medical therapy. In BMMC group 6 (10.9%) patients died at 12-month follow-up compared with 21 (38.9%) in control group (log-rank test, p = 0.0007). Intramyocardial bone marrow cell transplantation to patients with ischemic heart failure is safe and improved survival, clinical symptoms, and has beneficial effect on LV function.
Authors:
Evgeny Pokushalov; Alexander Romanov; Alexander Chernyavsky; Petr Larionov; Igor Terekhov; Sergey Artyomenko; Olga Poveshenko; Elena Kliver; Natalya Shirokova; Alexandr Karaskov; Nabil Dib
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2009-09-24
Journal Detail:
Title:  Journal of cardiovascular translational research     Volume:  3     ISSN:  1937-5395     ISO Abbreviation:  J Cardiovasc Transl Res     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-06-18     Completed Date:  2010-10-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101468585     Medline TA:  J Cardiovasc Transl Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  160-8     Citation Subset:  IM    
Affiliation:
State Research Institute of Circulation Pathology, Rechkunovskaya 15, 630055, Novosibirsk 55, Russia. E.Pokushalov@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Bone Marrow Transplantation* / adverse effects,  mortality
Female
Heart Failure / etiology,  mortality,  pathology,  physiopathology,  surgery*
Humans
Injections
Kaplan-Meiers Estimate
Male
Middle Aged
Myocardial Ischemia / complications,  mortality,  pathology,  physiopathology,  surgery*
Myocardium / pathology
Recovery of Function
Severity of Illness Index
Stroke Volume
Time Factors
Transplantation, Autologous
Treatment Outcome
Ventricular Function, Left

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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