Cited 36 times since 2006 (2 per year) source: EuropePMC American heart journal, Volume 152, Issue 4, 1 1 2006, Pages 684.e11-6 Sustained effect of autologous bone marrow mononuclear cell injection in patients with refractory angina pectoris and chronic myocardial ischemia: twelve-month follow-up results. Beeres SL, Bax JJ, Dibbets-Schneider P, Stokkel MP, Fibbe WE, van der Wall EE, Schalij MJ, Atsma DE
Background
Cell therapy has recently been introduced to treat patients with refractory angina. Because most studies have only included short-term follow-up, the effects of cell therapy over a longer period are unknown.
Methods
In 25 patients (mean age 64 +/- 10 years, 21 men) with refractory angina, a total of 84 +/- 29 x 10(6) bone marrow-derived mononuclear cells was injected intramyocardially in regions with ischemia on technetium-99m tetrofosmin single-photon emission computed tomography. Anginal symptoms and quality of life were evaluated at baseline and at 3, 6, and 12 months. Gated single-photon emission computed tomography was performed at baseline and at 3 and 12 months to assess myocardial perfusion and left ventricular function.
Results
Bone marrow cell injection was performed without any complication. At 7 months, one patient died of intracranial hemorrhage. Canadian Cardiovascular Society class improved from 3.4 +/- 0.5 to 2.3 +/- 0.6 at 3 months, 2.4 +/- 0.6 at 6 months, and 2.7 +/- 0.8 at 12 months (P < .01). Quality of life improved from 53% +/- 10% to 71% +/- 11% at 3 months, 72% +/- 14% at 6 months, and 68% +/- 14% at 12 months (P < .01). The number of segments with ischemia per patient decreased from 4.7 +/- 3.3 to 2.1 +/- 2.6 at 3 months and 1.6 +/- 2.5 at 12 months (P < .01). Left ventricular ejection fraction increased from 47% +/- 13% to 53% +/- 17% at 3 months and 51% +/- 17% at 12 months (P < .01). Regional wall motion improved from 5.9 +/- 1.7 to 6.6 +/- 2.2 mm at 3 months and 6.4 +/- 2.0 mm at 12 months (P = .01).
Conclusions
Autologous bone marrow cell injection in patients with ischemia is safe and results in a sustained beneficial effect on anginal symptoms, myocardial perfusion, and left ventricular function.
