Randomized Study of Mononuclear Bone Marrow Cell Transplantation in Patients With Coronary Surgery

• Published in: The Annals of thoracic surgery Vol. 86; no. 6; pp. 1833 - 1840
• Main Authors: Zhao, Qiang, MD, Sun, Yongxin, MD, Xia, Limin, MD, Chen, Anqing, MD, Wang, Zhe, MD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.12.2008; Elsevier
• Subjects: Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Bone Marrow Transplantation - methods; Bone Marrow Transplantation - mortality; Bone marrow, stem cells transplantation. Graft versus host reaction; Cardiology. Vascular system; Cardiothoracic Surgery; Combined Modality Therapy; Coronary Angiography - methods; Coronary Artery Bypass - methods; Coronary Artery Bypass - mortality; Coronary heart disease; Echocardiography, Doppler; Female; Follow-Up Studies; Graft Rejection; Graft Survival; Heart; Heart - physiology; Humans; Male; Medical sciences; Middle Aged; Myocardial Infarction - diagnosis; Myocardial Infarction - mortality; Myocardial Infarction - surgery; Neovascularization, Physiologic - physiology; Pneumology; Postoperative Complications - mortality; Probability; Prospective Studies; Reference Values; Regeneration - physiology; Risk Assessment; Severity of Illness Index; Surgery; Survival Analysis; Tomography, Emission-Computed, Single-Photon; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Transplantation, Autologous; Treatment Outcome; LM; TVD; VPBs; CPR; left ventricle; myocardial infarction; LVEF; LV; LVEDd; segmental resting score; infarction wall thickness; surgical left ventricle repair; left ventricular ejection fraction; triple-vessel disease; atrial fibrillation; percutaneous coronary intervention; cardiac care unit; left main disease; ventricular premature beats; left ventricle shortening fraction; MI; coronary artery bypass grafting; AF; MR; VF; intra-aortic balloon pulsation; ventricular tachycardia; left ventricle end-diastolic diameter; PCI; CABG; LVEDs; mitral valve regurgitation; single-photon emission computed tomography; VT; SVD; left ventricle end-systolic diameter; IABP; MVP; 29; mitrial valve plasty; SPECT; SVR; SRS; endothelial progenitor cells; mononuclear bone marrow cells; EPCs; OPCAB; ventricular fibrillation; IWT; cardiac pulmonary bypass; MN-BMC; single-vessel disease; double-vessel disease; DVD; infarction wall motion velocity; CCU; CPB; LVFS; IWMV; off-pump coronary artery bypass grafting; cardiac-pulmonary rescue; COPD; chronic obstructive pulmonary disease; Human; Coronary artery; Bone marrow transplantation; Cardiovascular disease; Patient; Coronary heart disease; Randomization; Mononuclear cell; Treatment; Surgery; Anesthesia; Clinical trial; Circulatory system; Cardiology
• ISSN: 0003-4975; 1552-6259
• DOI: 10.1016/j.athoracsur.2008.08.068

Background Mononuclear bone marrow cell (MN-BMC) transplantation has great clinical potential to promote myocardiogenesis and angiogenesis. This randomized study was designed to assess the feasibility and safety of MN-BMC transplantation during coronary artery bypass grafting (CABG) in patients with ischemic heart failure. Methods Thirty-six patients were prospectively enrolled and randomized to a MN-BMC group (n = 18) and a control group (n = 18). A mean number of 6.59 × 108 ± 5.12 × 108 MN-BMC were injected into the infarcted and marginal areas during CABG in the MN-BMC group. The patients in the control group underwent CABG alone. All patients were followed up to 6 months. Results There was one death in the MN-BMC group and no death in the control group. Two patients developed ventricular arrhythmia in the MN-BMC group. Compared with baseline and the control group, therapeutic effects of MN-BMC transplantation were observed over time. Heart function (New York Heart Association) was significantly improved and angina pectoris was alleviated in the MN-BMC group. Left ventricular ejection fraction in the MN-BMC group was greater than the control group. The thickness and motion velocity of the infarcted wall were significantly increased in the MN-BMC group. More pronounced perfusion improvements of ischemic regions and LV were observed in the MN-BMC group. There was one late death in the MN-BMC group. No procedure-related complications occurred. Conclusions MN-BMC transplantation improves cardiac function and regional perfusion in ischemic heart failure patients during CABG. A large cohort with long-term follow-up is needed to further evaluate the safety of MN-BMC transplantation.