Myocardial Regeneration by Intracoronary Infusion of Bone Marrow Cells Shows Limited Utility
September 3, 2008 – While a recent study into whether using unselected and selected bone-marrow derived cells can help with regeneration of heart tissue did not lead to significant improvement of LVEF and LV volumes in comparison to control group, there was a trend toward significant improvement of LVEF in patients with severely depressed baseline LVEF receiving either MNC or CD34 CXCR4 bone marrow cells
Michal Tendera, professor and chair of cardiology at the Upper-Silesian Cardiac Center, Silesian School of Medicine, Katowice, Poland, explained the findings of the REGENT study at the European Society of Cardiology 2008 Congress in Munich, Germany this week. It is the second-largest trial using bone marrow-derived cells in patients with acute MI and the first large trial for head-to-head comparison of selected and unselected cells
Intracoronary infusion of unselected and selected bone marrow cells proved to be safe and feasible, he said. The study treated patients with an intracoronary infusion of bone marrow-derived unselected mononuclear cells (MNC) and selected CD34 CXCR4 cells in 200 patients with acute myocardial infarction and reduced LVEF ≤ 40%.
Primary end-point was change of LV ejection fraction (LVEF) and volumes measured by MRI before and six months after the procedure.
In patients receiving both selected and unselected bone marrow cells, LVEF increased significantly in comparison to baseline values by 3 percent. This increase, however, was not significantly higher in comparison to the control group. The changes of left ventricular volumes were also comparable in all groups. Significant increase of LVEF was observed in patients treated with either type of bone marrow cells who had baseline LVEF less than the median. Baseline LVEF was an independent predictor of significant increase of LVEF. At the six-month clinical follow-up, the major cardiovascular event rate was low and no difference was seen between the groups.
Dr. Tendera concluded treatment with intracoronary infusion of BMC did not lead to significant improvement of LVEF and LV volumes in comparison to control group, however there was a trend towards significant improvement of LVEF in patients with severely depressed baseline LVEF receiving either MNC or CD34 CXCR4 bone marrow cells.
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