Author + information
- Received October 21, 2002
- Revision received February 5, 2003
- Accepted February 13, 2003
- Published online May 21, 2003.
- Shmuel Fuchs, MD*,* (, )
- Lowell F Satler, MD*,
- Ran Kornowski, MD†,
- Petros Okubagzi, MD*,
- Giora Weisz, MD‡,
- Richard Baffour, MD*,
- Ron Waksman, MD*,
- Neil J Weissman, MD*,
- Manuel Cerqueira, MD*,
- Martin B Leon, MD‡ and
- Stephen E Epstein, MD*
- ↵*Reprint requests and correspondence:
Dr. Shmuel Fuchs, Cardiovascular Research Institute, Washington Hospital Center, 110 Irving Street NW, 4B-1, Washington, DC 20010, USA.
Objectives We conducted a pilot study to evaluate the feasibility of transendocardial delivery of autologous bone marrow (ABM) strategy in patients with severe symptomatic chronic myocardial ischemia not amenable to conventional revascularization.
Background Transendocardial injection of ABM cells appears to enhance perfusion of ischemic porcine myocardium.
Methods Ten patients underwent transendocardial injection of freshly aspirated and filtered unfractionated ABM using left ventricular electromechanical guidance. Twelve injections of 0.2 ml each were successfully delivered into ischemic noninfarcted myocardium pre-identified by single-photon emission computed tomography perfusion imaging.
Results Autologous bone marrow injection was successful in all patients and was associated with no serious adverse effects; in particular, there was no arrhythmia, evidence of infection, myocardial inflammation, or increased scar formation. Two patients were readmitted for recurrent chest pain. At three months, Canadian Cardiovascular Society angina score significantly improved (3.1 ± 0.3 vs. 2.0 ± 0.94, p = 0.001), as well as stress-induced ischemia occurring within the injected territories (2.1 ± 0.8 vs. 1.6 ± 0.8, p < 0.001). Treadmill exercise duration, available in nine patients, increased, but the change was not significant (391 ± 155 vs. 485 ± 198, p = 0.11).
Conclusions This study provides preliminary clinical data indicating feasibility of catheter-based transendocardial delivery of ABM to ischemic myocardium.
☆ This research was supported by grants from the Cardiovascular Research Institute, Washington, DC; Cardiovascular Research Foundation, New York, New York; and MediVas LLC, San Diego, California.
Drs. Fuchs, Kornowski, Leon, and Epstein are minor shareholders in a startup company dedicated to the field of cell therapy for angiogenesis. They also have a pending patent for intramyocardial injection of autologous bone marrow.
- Received October 21, 2002.
- Revision received February 5, 2003.
- Accepted February 13, 2003.
- American College of Cardiology Foundation