Benefits Seen in Myocardial Bone Marrow Cell Injections
Patients with chronic myocardial ischemia showed perfusion improvement compared to placebo
TUESDAY, May 19 (HealthDay News) -- Injections of bone marrow cells into the myocardium of patients with chronic myocardial ischemia were associated with improved myocardial perfusion and left ventricular function, according to research published in the May 20 issue of JAMA.
Jan van Ramshorst, M.D., of the Leiden University Medical Center in the Netherlands, and colleagues analyzed data from 50 patients with severe angina despite optimal medical treatment, who were randomized to receive eight to 10 intramyocardial injections of autologous bone marrow-derived mononuclear cells or placebo.
At three months, the researchers found that the treated patients showed greater improvements in a summed stress score, a 17-segment score for stress myocardial perfusion assessed with single-photon emission computerized tomography (23.5 to 20.1 compared to 24.8 to 23.7 in the placebo group). The treatment was also associated with increased left ventricular ejection fraction, quality-of-life score, and exercise capacity.
"Animal model studies suggest that bone marrow cell therapy for ischemic heart disease may improve myocardial perfusion and contractile performance. These observations may be related to differentiation of bone marrow cells in endothelial cells, smooth muscle cells, or cardiac myocytes," the authors write. "In addition, the bone marrow cells may secrete paracrine factors that promote angiogenesis, exert cytoprotective effects, recruit resident cardiac stem cells, or alter mechanical properties of myocardial scar tissue."
Two co-authors reported relationships with medical equipment makers.