Transendocardial, Autologous Bone Marrow Cell Transplantation for Severe, Chronic Ischemic Heart Failure
Emerson C. Perin,Hans F. Dohmann,Radovan Borojevic,Suzana A. Silva,Andre L.S. Sousa,Claudio Tinoco Mesquita,Maria Isabel D. Rossi,Antonio Carlos Carvalho,Hélio S. Dutra,Hans J.F. Dohmann,Guilherme V. Silva,Luciano Belem,Ricardo Vivacqua,Fernando Oswaldo Dias Rangel,Roberto Esporcatte,Yong-Jian Geng,William K. Vaughn,Joao A.R. Assad,Evandro Tinoco Mesquita,James T. Willerson +19 more
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TLDR
The present study demonstrates the relative safety of intramyocardial injections of bone marrow–derived stem cells in humans with severe heart failure and the potential for improving myocardial blood flow with associated enhancement of regional and global left ventricular function.Abstract:
Background— This study evaluated the hypothesis that transendocardial injections of autologous mononuclear bone marrow cells in patients with end-stage ischemic heart disease could safely promote neovascularization and improve perfusion and myocardial contractility. Methods and Results— Twenty-one patients were enrolled in this prospective, nonrandomized, open-label study (first 14 patients, treatment; last 7 patients, control). Baseline evaluations included complete clinical and laboratory evaluations, exercise stress (ramp treadmill), 2D Doppler echocardiogram, single-photon emission computed tomography perfusion scan, and 24-hour Holter monitoring. Bone marrow mononuclear cells were harvested, isolated, washed, and resuspended in saline for injection by NOGA catheter (15 injections of 0.2 cc). Electromechanical mapping was used to identify viable myocardium (unipolar voltage ≥6.9 mV) for treatment. Treated and control patients underwent 2-month noninvasive follow-up, and treated patients alone underwen...read more
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TL;DR: The transplanted cells proliferate and augment left ventricular performance and therein ameliorate the heart failure symptoms.
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TL;DR: The potential hazards of cell transplantation are discussed, including the possibility of unexpected local or systemic toxicity or side effects, and its relationship to technical considerations.
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Cell therapy in the heart.
TL;DR: The current literature available on cell transplantation is discussed, covering studies ranging from animal models to clinical trials, and results from clinical trials show conflicting results.
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