OCUS ISSUE: CARDIAC REGENERATION egeneration of Human Infarcted Heart uscle by Intracoronary Autologous Bone Marrow ell Transplantation in Chronic Coronary Artery Disease

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 F-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. (J Am Coll Cardiol 2005;46:1651–8) © 2005 by the American College of ublished by Elsevier Inc. doi:10.1016/j.jacc.2005.01.069