BACKGROUND: The intracoronary application of autologous bone marrow cells has proven hitherto to be safe but not sufficiently effective in patients with ischemic cardiomyopathy. The interventional application of cells injected directly into the myocardium represents one possible approach to improve effectiveness. TECHNIQUES: The NOGA method is based on the CARTO technique, which has been evaluated extensively for safety and feasibility in patients with heart failure. In a first step, an electrically and anatomically exact map of the left ventricle is obtained. Guided by this three-dimensional map direct injection of the cells into the ischemic area can be easily performed. CLINICAL STUDIES: Since its introduction in 2002 many studies have proven the safety, feasibility and effectiveness of NOGA-guided regenerative therapy to the left ventricle. While several studies also suggest effectiveness regarding various parameters of left ventricular function, no larger multicenter study is available to date. Such studies with also clinical endpoints are currently ongoing. CONCLUSION: The currently available data support, but do not yet prove, the hypothesis that intramyocardial stem cell therapy using NOGA-guided injection into the myocardium is safe and feasible in both acute and chronic ischemic cardiomyopathy. Ongoing trials will reveal whether this approach will become the standard form for applying cell therapy to the heart.
BACKGROUND: The intracoronary application of autologous bone marrow cells has proven hitherto to be safe but not sufficiently effective in patients with ischemic cardiomyopathy. The interventional application of cells injected directly into the myocardium represents one possible approach to improve effectiveness. TECHNIQUES: The NOGA method is based on the CARTO technique, which has been evaluated extensively for safety and feasibility in patients with heart failure. In a first step, an electrically and anatomically exact map of the left ventricle is obtained. Guided by this three-dimensional map direct injection of the cells into the ischemic area can be easily performed. CLINICAL STUDIES: Since its introduction in 2002 many studies have proven the safety, feasibility and effectiveness of NOGA-guided regenerative therapy to the left ventricle. While several studies also suggest effectiveness regarding various parameters of left ventricular function, no larger multicenter study is available to date. Such studies with also clinical endpoints are currently ongoing. CONCLUSION: The currently available data support, but do not yet prove, the hypothesis that intramyocardial stem cell therapy using NOGA-guided injection into the myocardium is safe and feasible in both acute and chronic ischemic cardiomyopathy. Ongoing trials will reveal whether this approach will become the standard form for applying cell therapy to the heart.
Authors: Gerd P Meyer; Kai C Wollert; Joachim Lotz; Jan Steffens; Peter Lippolt; Stephanie Fichtner; Hartmut Hecker; Arnd Schaefer; Lubomir Arseniev; Bernd Hertenstein; Arnold Ganser; Helmut Drexler Journal: Circulation Date: 2006-03-06 Impact factor: 29.690
Authors: Volker Schächinger; Sandra Erbs; Albrecht Elsässer; Werner Haberbosch; Rainer Hambrecht; Hans Hölschermann; Jiangtao Yu; Roberto Corti; Detlef G Mathey; Christian W Hamm; Tim Süselbeck; Birgit Assmus; Torsten Tonn; Stefanie Dimmeler; Andreas M Zeiher Journal: N Engl J Med Date: 2006-09-21 Impact factor: 91.245
Authors: K A Jackson; S M Majka; H Wang; J Pocius; C J Hartley; M W Majesky; M L Entman; L H Michael; K K Hirschi; M A Goodell Journal: J Clin Invest Date: 2001-06 Impact factor: 14.808
Authors: Emerson C Perin; Hans F R Dohmann; Radovan Borojevic; Suzana A Silva; Andre L S Sousa; Claudio T Mesquita; Maria I D Rossi; Antonio C Carvalho; Helio S Dutra; Hans J F Dohmann; Guilherme V Silva; Luciano Belém; Ricardo Vivacqua; Fernando O D Rangel; Roberto Esporcatte; Yong J Geng; William K Vaughn; Joao A R Assad; Evandro T Mesquita; James T Willerson Journal: Circulation Date: 2003-04-21 Impact factor: 29.690
Authors: William Reed; Stephen J Noga; Adrian P Gee; Cliona M Rooney; John E Wagner; Jeffrey McCullough; David H McKenna; Theresa L Whiteside; Albert D Donnenberg; Acacia K Baker; Robert W Lindblad; Elizabeth L Wagner; Traci Heath Mondoro Journal: Transfusion Date: 2008-12-23 Impact factor: 3.157
Authors: Kenneth Dickstein; Alain Cohen-Solal; Gerasimos Filippatos; John J V McMurray; Piotr Ponikowski; Philip Alexander Poole-Wilson; Anna Strömberg; Dirk J van Veldhuisen; Dan Atar; Arno W Hoes; Andre Keren; Alexandre Mebazaa; Markku Nieminen; Silvia Giuliana Priori; Karl Swedberg Journal: Eur Heart J Date: 2008-09-17 Impact factor: 29.983
Authors: Olaf Bergmann; Ratan D Bhardwaj; Samuel Bernard; Sofia Zdunek; Fanie Barnabé-Heider; Stuart Walsh; Joel Zupicich; Kanar Alkass; Bruce A Buchholz; Henrik Druid; Stefan Jovinge; Jonas Frisén Journal: Science Date: 2009-04-03 Impact factor: 47.728
Authors: Emerson C Perin; Hans F R Dohmann; Radovan Borojevic; Suzana A Silva; Andre L S Sousa; Guilherme V Silva; Claudio T Mesquita; Luciano Belém; William K Vaughn; Fernando O D Rangel; Joao A R Assad; Antonio C Carvalho; Rodrigo V C Branco; Maria I D Rossi; Hans J F Dohmann; James T Willerson Journal: Circulation Date: 2004-09-14 Impact factor: 29.690