PMID- 16820557
OWN - NLM
STAT- MEDLINE
DCOM- 20060818
LR  - 20161124
IS  - 1524-4539 (Electronic)
IS  - 0009-7322 (Linking)
VI  - 114
IP  - 1 Suppl
DP  - 2006 Jul 4
TI  - Recovery of regional but not global contractile function by the direct 
      intramyocardial autologous bone marrow transplantation: results from a randomized 
      controlled clinical trial.
PG  - I101-7
AB  - BACKGROUND: Recent trials have shown that intracoronary infusion of bone marrow 
      cells (BMCs) improves functional recovery after acute myocardial infarction. 
      However, whether this treatment is effective in heart failure as a consequence of 
      remodeling after organized infarcts remains unclear. In this randomized trial, we 
      assessed the hypothesis that direct intramyocardial injection of autologous 
      mononuclear bone marrow cells during coronary artery bypass graft (CABG) could 
      improve global and regional left ventricular ejection fraction (LVEF) at 4-month 
      follow-up. METHODS AND RESULTS: Twenty patients (age 64.8+/-8.7; 17 male, 3 
      female) with a postinfarction nonviable scar, as assessed by thallium (Tl) 
      scintigraphy and cardiac magnetic resonance imaging (MRI), scheduled for elective 
      CABG, were included. They were randomized to a control group (n =10, CABG only) 
      or a BMC group (CABG and injection of 60.10(6)+/-31.10(6) BMC). Primary end 
      points were global LVEF change and wall thickening changes in the infarct area 
      from baseline to 4-month follow-up, as measured by MRI. Changes in metabolic 
      activity were measured by Tl scintigraphy and expressed as a score with a range 
      from 0 to 4, corresponding to percent of maximal myocardial Tl uptake (4 
      indicates <50%, nonviable scar; 3, 50% to 60%; 2, 60% to 70%; 1, 70% to 80%; 
      0>80%). Global LVEF at baseline was 39.5+/-5.5% in controls and 42.9+/-10.3% in 
      the BMC group (P=0.38). At 4 months, LVEF had increased to 43.1+/-10.9% in the 
      control group and to 48.9+/-9.5% in the BMC group (P=0.23). Systolic thickening 
      had improved from -0.6+/-1.3 mm at baseline to 1.8+/-2.6 mm at 4 months in the 
      cell-implanted scars, whereas nontreated scars remained largely akinetic 
      (-0.5+/-2.0 mm at baseline compared with 0.4+/-1.7 mm at 4 months, P=0.007 
      control versus BMC-treated group at 4 months). Defect score decreased from 4 to 
      3.3+/-0.9 in the BMC group and to 3.7+/-0.4 in the control group (P=0.18). 
      CONCLUSIONS: At 4 months, there was no significant difference in global LVEF 
      between both groups, but a recovery of regional contractile function in 
      previously nonviable scar was observed in the BMC group.
FAU - Hendrikx, Marc
AU  - Hendrikx M
AD  - Department of Cardiothoracic Surgery, Virga Jesse hospital, Stadsomvaart 11, 
      B-3500 Hasselt, Belgium. marc.hendrikx@virgajesse.be
FAU - Hensen, Karen
AU  - Hensen K
FAU - Clijsters, Christel
AU  - Clijsters C
FAU - Jongen, Hanne
AU  - Jongen H
FAU - Koninckx, Remco
AU  - Koninckx R
FAU - Bijnens, Eric
AU  - Bijnens E
FAU - Ingels, Michel
AU  - Ingels M
FAU - Jacobs, Axel
AU  - Jacobs A
FAU - Geukens, Robert
AU  - Geukens R
FAU - Dendale, Paul
AU  - Dendale P
FAU - Vijgen, Johan
AU  - Vijgen J
FAU - Dilling, Dagmara
AU  - Dilling D
FAU - Steels, Paul
AU  - Steels P
FAU - Mees, Urbain
AU  - Mees U
FAU - Rummens, Jean-Luc
AU  - Rummens JL
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - United States
TA  - Circulation
JT  - Circulation
JID - 0147763
RN  - 0 (Radiopharmaceuticals)
RN  - 0 (Thallium Radioisotopes)
SB  - IM
MH  - Aged
MH  - Bone Marrow Transplantation/*methods
MH  - Cicatrix/diagnostic imaging/pathology/surgery
MH  - Coronary Artery Bypass
MH  - Female
MH  - Flow Cytometry
MH  - Heart/diagnostic imaging
MH  - Humans
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - *Myocardial Contraction
MH  - Myocardial Infarction/diagnostic imaging/pathology/physiopathology/*surgery
MH  - Radionuclide Imaging
MH  - Radiopharmaceuticals/pharmacokinetics
MH  - Stroke Volume
MH  - Systole
MH  - Thallium Radioisotopes/pharmacokinetics
MH  - Transplantation, Autologous
EDAT- 2006/07/06 09:00
MHDA- 2006/08/19 09:00
CRDT- 2006/07/06 09:00
PHST- 2006/07/06 09:00 [pubmed]
PHST- 2006/08/19 09:00 [medline]
PHST- 2006/07/06 09:00 [entrez]
AID - 114/1_suppl/I-101 [pii]
AID - 10.1161/CIRCULATIONAHA.105.000505 [doi]
PST - ppublish
SO  - Circulation. 2006 Jul 4;114(1 Suppl):I101-7. doi: 
      10.1161/CIRCULATIONAHA.105.000505.