PMID- 18711405 OWN - NLM STAT- MEDLINE DCOM- 20081211 LR - 20080924 IS - 1743-4300 (Electronic) IS - 1743-4297 (Linking) VI - 5 IP - 10 DP - 2008 Oct TI - Randomized, controlled trial of intramuscular or intracoronary injection of autologous bone marrow cells into scarred myocardium during CABG versus CABG alone. PG - 663-70 LID - 10.1038/ncpcardio1321 [doi] AB - BACKGROUND: Studies of the transplantation of autologous bone marrow cells (BMCs) in patients with chronic ischemic heart disease have assessed effects on viable, peri-infarct tissue. We conducted a single-blinded, randomized, controlled study to investigate whether intramuscular or intracoronary administration of BMCs into nonviable scarred myocardium during CABG improves contractile function of scar segments compared with CABG alone. METHODS: Elective CABG patients (n = 63), with established myocardial scars diagnosed as akinetic or dyskinetic segments by dobutamine stress echocardiography and confirmed at surgery, were randomly assigned CABG alone (control) or CABG with intramuscular or intracoronary administration of BMCs. The BMCs, which were obtained at the time of surgery, were injected into the mid-depth of the scar in the intramuscular group or via the graft conduit supplying the scar in the intracoronary group. Contractile function was assessed in scar segments by dobutamine stress echocardiography before and 6 months after treatment. RESULTS: The proportion of patients showing improved wall motion in at least one scar segment after BMC treatment was not different to that observed in the control group (P = 0.092). Quantitatively, systolic fractional thickening in scar segments did not improve with BMC administration. Furthermore, BMCs did not improve scar transmurality, infarct volume, left ventricular volume, or ejection fraction. CONCLUSION: Injection of autologous BMCs directly into the scar or into the artery supplying the scar is safe but does not improve contractility of nonviable scarred myocardium, reduce scar size, or improve left ventricular function more than CABG alone. FAU - Ang, Keng-Leong AU - Ang KL AD - Cardiac Surgery Unit, Department of Cardiovascular Science, University of Leicester, UK. FAU - Chin, Derek AU - Chin D FAU - Leyva, Francisco AU - Leyva F FAU - Foley, Paul AU - Foley P FAU - Kubal, Chandrashekhar AU - Kubal C FAU - Chalil, Shajil AU - Chalil S FAU - Srinivasan, Lakshmi AU - Srinivasan L FAU - Bernhardt, Lizelle AU - Bernhardt L FAU - Stevens, Suzanne AU - Stevens S FAU - Shenje, Lincoln T AU - Shenje LT FAU - Galinanes, Manuel AU - Galinanes M LA - eng GR - PG04050/British Heart Foundation/United Kingdom PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20080819 PL - England TA - Nat Clin Pract Cardiovasc Med JT - Nature clinical practice. Cardiovascular medicine JID - 101226507 SB - IM MH - Aged MH - Bone Marrow Transplantation/*methods MH - *Coronary Artery Bypass MH - Echocardiography, Stress MH - Female MH - Humans MH - Male MH - Middle Aged MH - *Myocardial Contraction MH - Myocardial Infarction/pathology/physiopathology/*surgery MH - Myocardium/*pathology MH - Single-Blind Method MH - Time Factors MH - Transplantation, Autologous MH - Treatment Outcome MH - *Ventricular Function, Left EDAT- 2008/08/20 09:00 MHDA- 2008/12/17 09:00 CRDT- 2008/08/20 09:00 PHST- 2008/01/22 00:00 [received] PHST- 2008/07/03 00:00 [accepted] PHST- 2008/08/20 09:00 [pubmed] PHST- 2008/12/17 09:00 [medline] PHST- 2008/08/20 09:00 [entrez] AID - ncpcardio1321 [pii] AID - 10.1038/ncpcardio1321 [doi] PST - ppublish SO - Nat Clin Pract Cardiovasc Med. 2008 Oct;5(10):663-70. doi: 10.1038/ncpcardio1321. Epub 2008 Aug 19.