Published online before print September 8, 2005, doi: 10.1161/01.RES.0000185811.71306.8b
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
© 2005 American Heart Association, Inc.
Clinical Research |
Transplantation of Blood-Derived Progenitor Cells After Recanalization of Chronic Coronary Artery Occlusion
First Randomized and Placebo-Controlled Study
From the Department of Cardiology, Heart Center (S.E., A.L., V.A., K.L., H.T., K.-W.D., G.S., R.H.), Institute of Clinical Immunology and Transfusion Medicine (F.E.), and Department of Nuclear Medicine (R.K., K.K., O.S.), University of Leipzig, Germany.
Correspondence to Rainer Hambrecht, MD, Professor of Medicine, Dept of Internal Medicine/Cardiology, Univ of Leipzig, Heart Center, Struempellstrasse 39, 04289 Leipzig, Germany. E-mail hamr{at}medizin.uni-leipzig.de
Transplantation of blood-derived circulating progenitor cells (CPC) has been shown to improve myocardial regeneration after myocardial infarction. It remains unclear whether CPC transplantation exerts beneficial effects also in patients with chronic myocardial ischemia. We initiated a randomized, double-blind, placebo-controlled study evaluating the impact of intracoronary infusion of CPCs on coronary vasomotion and left ventricular (LV) function in patients after recanalization of chronic coronary total occlusion (CTO). After recanalization of CTO, 26 patients (age, 63±2 years; LV ejection fraction, 53±2%) were randomly assigned to the treatment (intracoronary transplantation of CPCs) or control group. Coronary flow reserve in response to adenosine (2.4 mg/min) was measured in the target vessel at the beginning of the study and after 3 months. LV function and infarct size were assessed by MRI and metabolism by 18F deoxyglucose positron emission tomography. CPC application resulted in an increase in coronary flow reserve by 43% from 2.3±0.3 to 3.3±0.5 (P<0.05 versus beginning and control). At 3 months, the number of hibernating segments in the target region (from 2.9±0.6 to 2.0±0.6 segments, P<0.05 versus beginning and control) had declined in the treatment group, whereas no significant changes were observed in the control group. MRI revealed a reduction in infarct size by 16% and an increase in LV ejection fraction by 14% in the treatment group (from 51.7±3.7 to 58.9±3.2%; P<0.05 versus beginning and control) because of an augmented wall motion in the target region. Hence, intracoronary transplantation of CPCs after recanalization of CTO results in an improvement of macro- and microvascular function and contributes to the recruitment of hibernating myocardium.
Key Words: ischemic heart disease • endothelial dysfunction • progenitor cells • hibernating myocardium • reperfusion
Related Article:
Circ. Res. 2005 97: 735-736.
This article has been cited by other articles:
 |
|
 |
|
  A. R. Pries, H. Habazettl, G. Ambrosio, P. R. Hansen, J. C. Kaski, V. Schachinger, H. Tillmanns, G. Vassalli, I. Tritto, M. Weis, et al. A review of methods for assessment of coronary microvascular disease in both clinical and experimental settings Cardiovasc Res, June 25, 2008; (2008) cvn136v2. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Tayyareci, M. Sezer, B. Umman, S. Besisik, A. Mudun, Y. Sanli, A. Oncul, N. Gurses, D. Sargin, M. Meric, et al. Intracoronary Autologous Bone Marrow-Derived Mononuclear Cell Transplantation Improves Coronary Collateral Vessel Formation and Recruitment Capacity in Patients With Ischemic Cardiomyopathy: A Combined Hemodynamic and Scintigraphic Approach Angiology, May 1, 2008; 59(2): 145 - 155. [Abstract] [PDF]
|
|
|
|
 |
|
 K. Kendziorra, H. Barthel, S. Erbs, F. Emmrich, R. Hambrecht, G. Schuler, O. Sabri, and R. Kluge Effect of Progenitor Cells on Myocardial Perfusion and Metabolism in Patients After Recanalization of a Chronically Occluded Coronary Artery J. Nucl. Med., April 1, 2008; 49(4): 557 - 563. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. K. Courtney, N. R. Munce, K. J. Anderson, A. S. Thind, G. Leung, P. E. Radau, F. S. Foster, I. A. Vitkin, R. S. Schwartz, A. J. Dick, et al. Innovations in imaging for chronic total occlusions: a glimpse into the future of angiography's blind-spot Eur. Heart J., March 1, 2008; 29(5): 583 - 593. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. K. Burt, Y. Loh, W. Pearce, N. Beohar, W. G. Barr, R. Craig, Y. Wen, J. A. Rapp, and J. Kessler Clinical Applications of Blood-Derived and Marrow-Derived Stem Cells for Nonmalignant Diseases JAMA, February 27, 2008; 299(8): 925 - 936. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Erbs, A. Linke, V. Schachinger, B. Assmus, H. Thiele, K.-W. Diederich, C. Hoffmann, S. Dimmeler, T. Tonn, R. Hambrecht, et al. Restoration of Microvascular Function in the Infarct-Related Artery by Intracoronary Transplantation of Bone Marrow Progenitor Cells in Patients With Acute Myocardial Infarction: The Doppler Substudy of the Reinfusion of Enriched Progenitor Cells and Infarct Remodeling in Acute Myocardial Infarction (REPAIR-AMI) Trial Circulation, July 24, 2007; 116(4): 366 - 374. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Abdel-Latif, R. Bolli, I. M. Tleyjeh, V. M. Montori, E. C. Perin, C. A. Hornung, E. K. Zuba-Surma, M. Al-Mallah, and B. Dawn Adult Bone Marrow-Derived Cells for Cardiac Repair: A Systematic Review and Meta-analysis Arch Intern Med, May 28, 2007; 167(10): 989 - 997. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. L.M.A. Beeres, F. M. Bengel, J. Bartunek, D. E. Atsma, J. M. Hill, M. Vanderheyden, M. Penicka, M. J. Schalij, W. Wijns, and J. J. Bax Role of Imaging in Cardiac Stem Cell Therapy J. Am. Coll. Cardiol., March 20, 2007; 49(11): 1137 - 1148. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. L. Sanchez, A. Villa, J. A. San Roman, T. Cantero, M. E. Fernandez, and F. Fernandez-Aviles Percutaneous bone-marrow-derived cell transplantation: clinical observations Eur. Heart J. Suppl., December 1, 2006; 8(suppl_H): H23 - H31. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Honold, R. Lehmann, C. Heeschen, D. H. Walter, B. Assmus, K.-I. Sasaki, H. Martin, J. Haendeler, A. M. Zeiher, and S. Dimmeler Effects of Granulocyte Colony Stimulating Factor on Functional Activities of Endothelial Progenitor Cells in Patients With Chronic Ischemic Heart Disease Arterioscler. Thromb. Vasc. Biol., October 1, 2006; 26(10): 2238 - 2243. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. J. Boyle, S. P. Schulman, and J. M. Hare Stem Cell Therapy for Cardiac Repair: Ready for the Next Step Circulation, July 25, 2006; 114(4): 339 - 352. [Full Text] [PDF]
|
|
|
|
|
|
H.-J. Kang, H.-Y. Lee, S.-H. Na, S.-A Chang, K.-W. Park, H.-K. Kim, S.-Y. Kim, H.-J. Chang, W. Lee, W. J. Kang, et al. Differential Effect of Intracoronary Infusion of Mobilized Peripheral Blood Stem Cells by Granulocyte Colony-Stimulating Factor on Left Ventricular Function and Remodeling in Patients With Acute Myocardial Infarction Versus Old Myocardial Infarction: The MAGIC Cell-3-DES Randomized, Controlled Trial Circulation, July 4, 2006; 114(1_suppl): I-145 - I-151. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Erbs, A. Linke, G. Schuler, and R. Hambrecht Intracoronary Administration of Circulating Blood-Derived Progenitor Cells After Recanalization of Chronic Coronary Artery Occlusion Improves Endothelial Function Circ. Res., March 17, 2006; 98(5): e48 - e48. [Full Text] [PDF]
|
|
|
|
|
|
J. H. Traverse CPCs as Treatment for Chronic Total Coronary Artery Occlusions Circ. Res., January 6, 2006; 98(1): e1 - e1. [Full Text] [PDF]
|
|
|
|
|
|
J. T. Willerson, E. T.H. Yeh, Y.-J. Geng, and E. C. Perin Blood-Derived Progenitor Cells After Recanalization of Chronic Coronary Artery Occlusions in Humans Circ. Res., October 14, 2005; 97(8): 735 - 736. [Full Text] [PDF]
|
|