Literature DB >> 17652881

Intracoronary transplantation of non-expanded peripheral blood-derived mononuclear cells promotes improvement of cardiac function in patients with acute myocardial infarction.

Tetsuya Tatsumi1, Eishi Ashihara, Toshihide Yasui, Shinsaku Matsunaga, Atsumichi Kido, Yuji Sasada, Satoshi Nishikawa, Mitsuyoshi Hadase, Masahiro Koide, Reo Nakamura, Hidekazu Irie, Kazuki Ito, Akihiro Matsui, Hiroyuki Matsui, Maki Katamura, Shigehiro Kusuoka, Satoaki Matoba, Satoshi Okayama, Manabu Horii, Shiro Uemura, Chihiro Shimazaki, Hajime Tsuji, Yoshihiko Saito, Hiroaki Matsubara.   

Abstract

BACKGROUND: Transplantation of non-expanded peripheral blood mononuclear cells (PBMNCs) enhances neovessel formation in ischemic myocardium and limbs by releasing angiogenic factors. This study was designed to examine whether intracoronary transplantation of PBMNCs improves cardiac function after acute myocardial infarction (AMI). METHODS AND
RESULTS: After successful percutaneous coronary intervention (PCI) for a ST-elevation AMI with occlusion of proximal left anterior descending coronary artery within 24 h, patients received an intracoronary infusion of PBMNCs within 5 days after PCI (PBMNC group). PBMNCs were obtained from patients by COBE spectra-apheresis and concentrated to 10 ml, 3.3 ml of which was infused via over-the-wire catheter. The global left ventricular ejection fraction (LVEF) change from baseline to 6 months followup in th ePBMNC group that underwent standard PCI for similar AMI [corrected]. The primary endpoint was the global left ventricular ejection fraction (LVEF) change from baseline to 6 months' follow-up. The data showed that the absolute increase in LVEF was 7.4% in the control group and 13.4% (p=0.037 vs control) in the PBMNC group. Cell therapy resulted in a greater tendency of DeltaRegional ejection fraction (EF) or significant improvement in the wall motion score index and Tc-99m-tetrofosmin perfusion defect score associated with the infarct area, compared with controls. Moreover, intracoronary administration of PBMNCs did not exacerbate either left ventricular (LV) end-diastolic and end-systolic volume expansion or high-risk arrhythmia, without any adverse clinical events.
CONCLUSION: Intracoronary infusion of non-expanded PBMNCs promotes improvement of LV systolic function. This less invasive and more feasible approach to collecting endothelial progenitor cells may provide a novel therapeutic option for improving cardiac function after AMI.

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Year:  2007        PMID: 17652881     DOI: 10.1253/circj.71.1199

Source DB:  PubMed          Journal:  Circ J        ISSN: 1346-9843            Impact factor:   2.993


  23 in total

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