Endomyocardial injection of bone marrow cells improves severe CAD
Date: Wed, 16 January 2008
by Martha Kerr
Injections of autologous bone marrow cells (BMC) directly into the
endomyocardium of no-option patients with severe coronary artery
disease (CAD) improves left ventricular ejection fraction and
exercise tolerance, results of the international PROTECT-CAD trial
show.
The findings are published in the December issue of the European
Heart Journal.
"Our study is the first randomized controlled clinical trial on the
use of bone marrow stem cells to treat patients with chronic severe
coronary artery disease without other options," lead investigator Dr.
Hung-Fat Tse of the University of Hong Kong Dr. Tse told Reuters
Health.
In the trial, involving 28 patients with severe CAD, bone marrow
cells were harvested and patients were randomized to low-dose or high-
dose autologous BMC injections directly into the endomyocardium, or
to a control procedure consisting of injection of autologous plasma.
"In our study, direct intramyocardial injection of bone marrow cells
is performed with a catheter-based procedure without the need for
open heart surgery," Dr. Tse explained. "Furthermore, the approach
(allows) the delivery of stem cells directly into the heart muscle,
even in patients with complete occlusion of their arteries."
Patients received a mean of 14.6 injections targeted under single-
photon emission computed tomography (SPECT) and magnetic resonance
imaging (MRI) guidance to ischemic areas of the myocardium.
Baseline exercise treadmill time was 439 seconds in controls and 393
in study subjects. At six months, treadmill time had deteriorated to
383 seconds in controls but improved to 464 seconds in BMC-treated
patients.
Compared to control injections, BMC injections resulted in a
significant increase in LVEF and a decrease in New York Heart
Association (NYHA) class at six months, but Canadian Cardiovascular
Society (CCS) class was reduced similarly in both groups.
There were no acute or long-term complications, including ventricular
arrhythmias, myocardial damage or development of intramyocardial
tumor or calcification associated with BMC implantation.
"Our results demonstrate that this treatment is a safe and feasible
therapy in patients with end-stage coronary artery disease to improve
their symptoms and functional capacity," Dr. Tse commented. "In this
study, most of the patients still had a relatively normal or mildly
impaired heart failure. In the next study that we have planned,
patients with poorer heart function will be recruited to test whether
this therapy can improve heart failure in those patients."
Source:
Reutershttp:
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StemCells subscribers may also be interested in these sites:
Children's Neurobiological Solutions
http://www.CNSfoundation.org/
Cord Blood Registry
http://www.CordBlood.com/at.cgi?a=150123
The CNS Healing Group
http://groups.yahoo.com/group/CNS_Healing
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