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J Am Coll Cardiol, 2005; 46:1651-1658, doi:10.1016/j.jacc.2005.01.069
© 2005 by the American College of Cardiology Foundation
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FOCUS ISSUE: CARDIAC REGENERATION

Regeneration of Human Infarcted Heart Muscle by Intracoronary Autologous Bone Marrow Cell Transplantation in Chronic Coronary Artery Disease

The IACT Study

Bodo E. Strauer, MD*,*, Michael Brehm, MD*, Tobias Zeus, MD*, Thomas Bartsch, MD*, Christina Schannwell, MD*, Christine Antke, MD{dagger}, Rüdiger V. Sorg, PhD{ddagger}, Gesine Kögler, PhD{ddagger}, Peter Wernet, MD{ddagger}, Hans-Wilhelm Müller, MD{dagger} and Matthias Köstering, MD*

* Department of Internal Medicine, Division of Cardiology, Pneumology and Angiology, Heinrich-Heine-University, Düsseldorf, Germany
{dagger} Department of Nuclear Medicine, Heinrich-Heine-University, Düsseldorf, Germany
{ddagger} Institute for Transplantation Diagnostics and Cell Therapeutics, Heinrich-Heine-University, Düsseldorf, Germany

Manuscript received October 31, 2004; revised manuscript received December 13, 2004, accepted January 25, 2005.

* Reprint requests and correspondence: Dr. Bodo E. Strauer, Head of Department of Medicine, Division of Cardiology, Pneumology, and Angiology, Heinrich-Heine-University, Moorenstr. 5, 40225 Düsseldorf, Germany. (Email: strauer{at}med.uni-duesseldorf.de).

OBJECTIVES: Stem cell therapy may be useful in chronic myocardial infarction (MI); this is conceivable, but not yet demonstrated in humans.

BACKGROUND: After acute MI, bone marrow-derived cells improve cardiac function.

METHODS: We treated 18 consecutive patients with chronic MI (5 months to 8.5 years old) by the intracoronary transplantation of autologous bone marrow mononuclear cells and compared them with a representative control group without cell therapy.

RESULTS: After three months, in the transplantation group, infarct size was reduced by 30% and global left ventricular ejection fraction (+15%) and infarction wall movement velocity (+57%) increased significantly, whereas in the control group no significant changes were observed in infarct size, left ventricular ejection fraction, or wall movement velocity of infarcted area. Percutaneous transluminal coronary angioplasty alone had no effect on left ventricular function. After bone marrow cell transplantation, there was an improvement of maximum oxygen uptake (VO2max, +11%) and of regional 18F-fluor-desoxy-glucose uptake into infarct tissue (+15%).

CONCLUSIONS: These results demonstrate that functional and metabolic regeneration of infarcted and chronically avital tissue can be realized in humans by bone marrow mononuclear cell transplantation.

Abbreviations and Acronyms
  BMC = bone marrow mononuclear cell
  CPK = creatine phosphokinase
  ECG = electrocardiogram
  LV = left ventricular
  MI = myocardial infarction
  PET = positron emission tomography
  PTCA = percutaneous transluminal coronary angioplasty
  Tx group = transplantation group


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