Cardiology Online

16th World Congress on Heart Disease

controversies meeting



Intracoronary Injection of Mononuclear Bone Marrow Cells in Acute Myocardial Infarction Found No Effects on Global Left Ventricular Function

October 16, 2006

By Sahar Bedrood B.S. and Asher Kimchi M.D.

Oslo, Norway- The net loss of cardiomyocytes during myocardial infarction is a key factor in the impairment of cardiac-pump function. The bone marrow contains stem cells that have shown promising results in solid-organ repair and regeneration.  Ketil Lunde M.D. et al from the Rikshospitalet University Hospital in Oslo, Norway designed a randomized, controlled trial to investigate the effects of intracoronary injection of autologous cells from bone marrow (BMC) in the acute phase of myocardial infarction. They investigated whether there was any improvement in left ventricular function after the treatment. The study, published in the September 21, 2006 issue of The New England Journal of Medicine, found no effects of intracoronary injection of autologous mononuclear BMC on global left ventricular function.

Patients with acute ST-elevation myocardial infarction of the anterior wall treated with percutanous coronary intervention were randomly assigned to the group that underwent intracoronary injection of autologous mononuclear BMC or the control group. No aspiration or sham injection was performed in the control group.  Left ventricular function was assessed with the use of electrocardiogram-gated single-photon emission computed tomography (SPECT) and echocardiography at baseline and magnetic resonance imaging (MRI) 2 to 3 weeks after the infarction. These procedures were repeated 6 months after the infarction. End points were changes in the left ventricular ejection fraction (LVEF), end-diastolic volume, and infarct size.

The trial had 47 patients undergo intracoronary injection of the mononuclear bone marrow cells at a median of 6 days after myocardial infarction. There were 50 patients in the control group. The mean change in LVEF between baseline and 6 months after infarction for all patients was 7.6 +/- 10.4 percentage points. The effect of BMC treatment on the change in LVEF was an increase of 0.6 percentage point (95% confidence interval, -3.4% to 4.6; P=0.77) on SPECT, an increase of 0.6 percentage point (95% confidence interval, -2.6 to 3.8; P=0.70) on echocardiography, and a decrease of 3.0 percentage points (95% confidence interval, 0.1 to –6.1; P= 0.054) on MRI. The two groups did not differ significantly in changes in left ventricular end-diastolic volume or infarct size.

The study concluded they found no effects of intracoronary injection of autologous mononuclear BMC on global left ventricular function.

Co-authors: Ketil Lunde, M.D., Svein Solheim, M.D., Svend Aakhus, M.D., Ph.D., Harald Arnesen, M.D., Ph.D., Michael Abdelnoor, Ph.D., Torstein Egeland, M.D., Ph.D., Knut Endresen, M.D., Ph.D., Arnfinn Ilebekk, M.D., Ph.D., Arild Mangschau, M.D., Ph.D., Jan G. Fjeld, M.D., Ph.D., Hans Jørgen Smith, M.D., Ph.D., Eli Taraldsrud, M.D., Haakon Kiil Grøgaard, M.D., Reidar Bjørnerheim, M.D., Ph.D., Magne Brekke, M.D., Carl Müller, M.D., Einar Hopp, M.D., Asgrimur Ragnarsson, M.D., Jan E. Brinchmann, M.D., Ph.D., and Kolbjørn Forfang, M.D., Ph.D.


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