Repair of old myocardial infarction by intracoronary transplantation of autologous bone marrow mesenchymal stem cells: a pilot clinical trial

ABSTRACT

Experimental and clinical studies have shown that intracoronary transplantation of autologous bone marrow mesenchymal stem cells [BMSCs] has resulted in regenerated infarcted myocardium and improved left ventricular [LV] function. The aim of this pilot study was to assess the benefical effects of intracoronary transplantation of BMSC in patients with old myocardial infarction [OMI]. Autologous BMSCs were transplanted by the intracoronary method via percutaneous transluminal coronary balloon angioplasty [PTCA] in five patients with old myocardial infarction. Time from myocardial infarction [MI] to cell therapy was 5.2 +/- 3.11 months [mean +/- SD]. All patients were <70 years old [32-61 years] and had significant LV dysfunction [LV ejection fraction, mean +/- SD, 34% +/- 10.83%], and severe wall motion abnormality [akinesia and / dyskinesia] at the location of infarcted area. Follow up angiography was performed 6-9 months [mean +/- SD,7 +/- 1.4 months] after BMSC transplantation, which revealed an increased trend in the LV ejection fraction [LVEF] of patients after treatment [LVEF Mean +/- SD from 34% +/- 10.83% to 46.25% +/- 9.46%, P= 0.051 and median from 35% to 42.5%]. Clinical follow up [for 12-18 months] also revealed appreciable improvement in their symptoms or functional class [dyspnea from New York Heart Association[NYHA]-Class Sha-IV to I-II and Chest discomfort from Canadian Cardiovascular Society [CCS] Class II-IV to I-II]. Intracoronary transplantation of autologous BMSC in patients with old myocardial infarction appears to be feasible, safe and effective .The therapeutic effect could be attributed to BMSCs ability to regenerate myocardium