Intracoronary autologous bone marrow-derived stem cell transplantation in patients with ischemic cardiomyopathy: results of 18-month follow-up

OBJECTIVES
It has been demonstrated that intracoronary stem cell transplantation may have beneficial effects on left ventricular function and perfusion both in patients with acute and chronic ischemic cardiomyopathy (ICMP). We evaluated the safety and feasibility of intracoronary autologous bone marrow-derived mononuclear stem cell (MSC) implantation in patients with ICMP.

STUDY DESIGN
The study included 15 patients (14 males, 1 female; mean age 49±11 years) with ICMP. All the patients received MSC transplantation via a balloon catheter to the target vessel which had been revascularized by percutaneous coronary intervention and was patent before the procedure. Evaluations were made at baseline and 6, 12, and 18 months after the procedure with complete clinical and laboratory examinations, and by treadmill exercise test, conventional echocardiography, and SPECT imaging.

RESULTS
At six months, left ventricular ejection fraction increased significantly (p=0.001), hypoperfused areas on SPECT images reduced (p=0.002), and both myocardial oxygen consumption (p=0.001) and metabolic equivalents (p=0.001) increased. These beneficial effects of stem cell therapy were also observed at 12 and 18 months. No complications or in-hospital events occurred related with the procedure.

CONCLUSION
Due to its beneficial effects on heart failure symptoms, left ventricular function, and perfusion, intracoronary stem cell transplantation can be used as an alternative, adjunctive treatment option in patients with ICMP.