Regeneration of Human Infarcted Heart Muscle by Intracoronary Autologous Bone Marrow Cell Transplantation in Chronic Coronary Artery Disease

• Published in: Journal of the American College of Cardiology 2005-11, Vol.46 (9), p.1651-1658
• Main Authors: Strauer, Bodo E., Brehm, Michael, Zeus, Tobias, Bartsch, Thomas, Schannwell, Christina, Antke, Christine, Sorg, Rüdiger V., Kögler, Gesine, Wernet, Peter, Müller, Hans-Wilhelm, Köstering, Matthias
• Format: Article
• Language: English
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/j.jacc.2005.01.069

Regeneration of Human Infarcted Heart Muscle by Intracoronary Autologous Bone Marrow Cell Transplantation in Chronic Coronary Artery Disease: The IACT Study Bodo E. Strauer, Michael Brehm, Tobias Zeus, Thomas Bartsch, Christina Schannwell, Christine Antke, Rüdiger V. Sorg, Gesine Kögler, Peter Wernet, Hans-Wilhelm Müller, Matthias Köstering Adult stem cell therapy is beneficial in patients after acute myocardial infarction, but its effects in chronically infarcted hearts are unknown. We treated 18 patients with intracoronary transplantation of autologous mononuclear bone marrow cells (BMC). After three months, infarct size was reduced (−30%) and global (+15%) and regional (+57%) left ventricular function improved significantly in the transplantation group in comparison with a control group. Moreover, there was an improvement of maximum oxygen uptake (+11%) and regional myocardial metabolism (+ 15%). These results demonstrate that functional and metabolic regeneration of chronically infarcted tissue can be realized by BMC transplantation. Stem cell therapy may be useful in chronic myocardial infarction (MI); this is conceivable, but not yet demonstrated in humans. After acute MI, bone marrow-derived cells improve cardiac function. We treated 18 consecutive patients with chronic MI (5 months to 8.5 years old) by the intracoronary transplantation of autologous bone marrow mononuclear cells and compared them with a representative control group without cell therapy. After three months, in the transplantation group, infarct size was reduced by 30% and global left ventricular ejection fraction (+15%) and infarction wall movement velocity (+57%) increased significantly, whereas in the control group no significant changes were observed in infarct size, left ventricular ejection fraction, or wall movement velocity of infarcted area. Percutaneous transluminal coronary angioplasty alone had no effect on left ventricular function. After bone marrow cell transplantation, there was an improvement of maximum oxygen uptake (Vo2max, +11%) and of regional 18F-fluor-desoxy-glucose uptake into infarct tissue (+15%). These results demonstrate that functional and metabolic regeneration of infarcted and chronically avital tissue can be realized in humans by bone marrow mononuclear cell transplantation.