Autologous bone-marrow mononuclear cell transplantation after acute myocardial infarction: comparison of two delivery techniques

Autologous bone-marrow mononuclear cell transplantation after acute myocardial infarction: comparison of two delivery techniques

The objective of this study was to investigate safety and feasibility of autologous bone marrow mononuclear cells (BMMNC) transplantation in ST elevation myocardial infarction (STEMI), comparing anterograde intracoronary artery (ICA) delivery with retrograde intracoronary vein (ICV) approach. An ope...

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Bibliographic Details
Published in:Cell transplantation Vol. 18; no. 3; p. 343
Main Authors: Silva, Suzana A, Sousa, André L S, Haddad, Andrea F, Azevedo, Jader C, Soares, Vinicio E, Peixoto, Cíntia M, Soares, Ana J S, Issa, Aurora F C, Felipe, Luis Renato V, Branco, Rodrigo V C, Addad, João A, Moreira, Rodrigo C, Tuche, Fabio A A, Mesquita, Cláudio T, Drumond, Cristina C O, Junior, Amarino O, Rochitte, Carlos E, Luz, José H M, Rabischoffisky, Arnaldo, Nogueira, Fernanda B, Vieira, Rosana B C, Junior, Hamilton S, Borojevic, Radovan, Dohmann, Hans F R
Format: Journal Article
Language:English
Published: United States SAGE Publishing 01-03-2009
Subjects:
Acute Disease
Adolescent
Adult
Aged
Aged, 80 and over
Bone Marrow Transplantation - methods
Demography
Female
Humans
Injections
Leukocytes, Mononuclear - transplantation
Male
Middle Aged
Myocardial Infarction - therapy
Nitrates
Radionuclide Ventriculography
Technetium Tc 99m Exametazime
Technetium Tc 99m Sestamibi
Transplantation, Autologous
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Summary:The objective of this study was to investigate safety and feasibility of autologous bone marrow mononuclear cells (BMMNC) transplantation in ST elevation myocardial infarction (STEMI), comparing anterograde intracoronary artery (ICA) delivery with retrograde intracoronary vein (ICV) approach. An open labeled, randomized controlled trial of 30 patients admitted with STEMI was used. Patients were enrolled if they 1) were successfully reperfused within 24 h from symptoms onset and 2) had infarct size larger than 10% of the left ventricle (LV). One hundred million BMMNC were injected in the infarct-related artery (intra-arterial group) or vein (intravenous group), 1% of which was labeled with Tc(99m)-hexamethylpropylenamineoxime. Cell distribution was evaluated 4 and 24 h after injection. Baseline MRI was performed in order to evaluate microbstruction pattern. Baseline radionuclide ventriculography was performed before cell transfer and after 3 and 6 months. All the treated patients were submitted to repeat coronary angiography after 3 months. Thirty patients (57 +/- 11 years, 70% males) were randomly assigned to ICA (n = 14), ICV (n = 10), or control (n = 6) groups. No serious adverse events related to the procedure were observed. Early and late retention of radiolabeled cells was higher in the ICA than in the ICV group, independently of microcirculation obstruction. An increase of EF was observed in the ICA group (p = 0.02) compared to baseline. Injection procedures through anterograde and retrograde approaches seem to be feasible and safe. BMMNC retention by damaged heart tissue was apparently higher when the anterograde approach was used. Further studies are required to confirm these initial data.
ISSN:0963-6897
1555-3892
DOI:10.3727/096368909788534951