Intramyocardial stem cell injection in patients with ischemic cardiomyopathy: Functional recovery and reverse remodeling

Adam R. Williams, Barry Trachtenberg, Darcy L. Velazquez, Ian McNiece, Peter Altman, Didier Rouy, Adam M. Mendizabal, Pradip Pattany, Gustavo A. Lopera, Joel Fishman, Juan P. Zambrano, Alan W. Heldman, Joshua Hare

Research output: Contribution to journalArticle

221 Citations (Scopus)

Abstract

Rationale: Transcatheter, intramyocardial injections of bone marrow-derived cell therapy produces reverse remodeling in large animal models of ischemic cardiomyopathy. Objective: We used cardiac MRI (CMR) in patients with left ventricular (LV) dysfunction related to remote myocardial infarction (MI) to test the hypothesis that bone marrow progenitor cell injection causes functional recovery of scarred myocardium and reverse remodeling. Methods and results: Eight patients (aged 57.2±13.3 years) received transendocardial, intramyocardial injection of autologous bone marrow progenitor cells (mononuclear or mesenchymal stem cells) in LV scar and border zone. All patients tolerated the procedure with no serious adverse events. CMR at 1 year demonstrated a decrease in end diastolic volume (208.7±20.4 versus 167.4±7.32 mL; P=0.03), a trend toward decreased end systolic volume (142.4±16.5 versus 107.6±7.4 mL; P=0.06), decreased infarct size (P<0.05), and improved regional LV function by peak Eulerian circumferential strain in the treated infarct zone (-8.1±1.0 versus -11.4±1.3; P=0.04). Improvements in regional function were evident at 3 months, whereas the changes in chamber dimensions were not significant until 6 months. Improved regional function in the infarct zone strongly correlated with reduction of end diastolic volume (r=0.69, P=0.04) and end systolic volume (r=0.83, P=0.01). Conclusions: These data suggest that transcatheter, intramyocardial injections of autologous bone marrow progenitor cells improve regional contractility of a chronic myocardial scar, and these changes predict subsequent reverse remodeling. The findings support the potential clinical benefits of this new treatment strategy and ongoing randomized clinical trials.

Original languageEnglish
Pages (from-to)792-796
Number of pages5
JournalCirculation Research
Volume108
Issue number7
DOIs
StatePublished - Apr 1 2011

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Cardiomyopathies
Bone Marrow Cells
Stem Cells
Injections
Cicatrix
Left Ventricular Dysfunction
Cell- and Tissue-Based Therapy
Mesenchymal Stromal Cells
Left Ventricular Function
Myocardium
Randomized Controlled Trials
Animal Models
Myocardial Infarction
Therapeutics

Keywords

  • bone marrow
  • heart failure
  • reverse remodeling
  • stem cells

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Intramyocardial stem cell injection in patients with ischemic cardiomyopathy : Functional recovery and reverse remodeling. / Williams, Adam R.; Trachtenberg, Barry; Velazquez, Darcy L.; McNiece, Ian; Altman, Peter; Rouy, Didier; Mendizabal, Adam M.; Pattany, Pradip; Lopera, Gustavo A.; Fishman, Joel; Zambrano, Juan P.; Heldman, Alan W.; Hare, Joshua.

In: Circulation Research, Vol. 108, No. 7, 01.04.2011, p. 792-796.

Research output: Contribution to journalArticle

Williams, AR, Trachtenberg, B, Velazquez, DL, McNiece, I, Altman, P, Rouy, D, Mendizabal, AM, Pattany, P, Lopera, GA, Fishman, J, Zambrano, JP, Heldman, AW & Hare, J 2011, 'Intramyocardial stem cell injection in patients with ischemic cardiomyopathy: Functional recovery and reverse remodeling', Circulation Research, vol. 108, no. 7, pp. 792-796. https://doi.org/10.1161/CIRCRESAHA.111.242610
Williams, Adam R. ; Trachtenberg, Barry ; Velazquez, Darcy L. ; McNiece, Ian ; Altman, Peter ; Rouy, Didier ; Mendizabal, Adam M. ; Pattany, Pradip ; Lopera, Gustavo A. ; Fishman, Joel ; Zambrano, Juan P. ; Heldman, Alan W. ; Hare, Joshua. / Intramyocardial stem cell injection in patients with ischemic cardiomyopathy : Functional recovery and reverse remodeling. In: Circulation Research. 2011 ; Vol. 108, No. 7. pp. 792-796.
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