Regeneration of Human Infarcted Heart Muscle by Intracoronary Autologous Bone Marrow Cell Transplantation in Chronic Coronary Artery Disease
Bodo E. Strauer, Michael Brehm, Tobias Zeus, Thomas Bartsch, Christiana Schannwell, Christine Antke, Rüdiger Sorg, Gesine Kögler, Peter Wernet, Hans-Wilhelm Müller, Matthais Köstering
Journal of the American College of Cardiology 2005;46:1651-1658.
Cardiac performance after myocardial infarction (MI) is compromised by ventricular remodeling, which represents a major cause of late infarct-related chronic heart failure and death (1,2).
Although conventional drug therapy (e.g., with beta-receptor blockers and/or angiotensin-converting enzyme inhibitors) may delay remodeling, there is no basic therapeutic regimen available for preventing or even reversing this process.
By the use of interventional therapeutics (percutaneous transluminal coronary angioplasty [PTCA] , stent), recanalization of the occluded infarct-related artery is possible, thereby improving or normalizing coronary blood flow. However, despite sufficient reperfusion of infracted tissue, the viability of the infarcted myocardium cannot, or can only insufficiently, be improved in most of these patients (3). Therefore, catheter-based therapy of acute MI is useful for vascular recanalization, but the second and crucial step, the regeneration of necrotic heart muscle, is not realized by this vascular procedure alone.
Experimental (4) and clinical (5,6) studies have shown recently for the first time that bone marrow mononuclear cells (BMCs) may regenerate damaged myocardium in acute MI in humans. Because the regenerative potential of bone marrow-derived cells ought also to be expected to exist in chronically ischemic heart disease as well (7-12), we have assembled in an ongoing clinical investigation 18 patients with chronic MI to prove this new therapeutic possibility.