Efficacy and long-term evaluation of intramyocardial injection of autologous CD34-enriched PBMSC in old myocardial infarction

José Luis Aceves, Abel Archundia, Araceli Páez, Rafael Vilchis, Elvira Varela, Emma Rodriguez, Guillermo Diaz, Lourdes Flores-Luna, Martha Alvarado, Manuel Lopez H., Luis Felipe Montaño, Felipe Masso

Center of Population Health Research, National Institute of Public Health, Mexico City, Mexico.
Department of Cardiovascular Surgery, National Medic Center 20 de Noviembre ISSSTE, Mexico City, Mexico.
Department of Cellular Physiology, National Institute of Cardiology “Ignacio Chavez”, Mexico City, Mexico.
Department of Hematology, National Medic Center 20 de Noviembre ISSSTE, Mexico City, Mexico.
Immunobiology Laboratory, Department of Cell and Tissue Biology, School of Medicine UNAM, Mexico City, Mexico.

DOI: 10.4236/wjcd.2012.24044                

Abstract

Aims: We have shown that autologous transplant of CD34⁺-enriched peripheral-blood mononuclear cells (PBMSC) could restore depressed myocardial function, and sustain adequate myocardial function 12 months after surgery in patients with old (>one year-old) myocardial infarction. Our aim is to report the long-term morbidity and mortality efficacy of this procedure. Methods and results: Seventy patients with an old anteroseptal myocardial infarction were followed for 2 to 7 years, 35 had a revascularization procedure and received an intra-myocardial injection of autologous CD34⁺-enriched PBMSC (8 × 108 mononuclear cells/ml including 3 × 107 CD34⁺ cells/ml)(Group A). Group B patients only had the revascularization. Abnormal pre-surgical values of LVEF (33.2% ± 4.8%), LVDV (178 ± 13.7 ml), LVSV (120 ± 16 m), LVDD (58.9 ± 3.84 mm), E and A waves without contractility in infarction area in group A patients improved to approximate normal values (50% ± 3% for LVEF; 90 ± 9.3 ml for LVDV; 80 ± 9.9 ml for LVSV; 55.3 ± 3 mm for LVDD; 5.2 ± 0.5 cm/s for E wave and 4.18 ± 0.3 cm/s for A wave) 1 year after the procedure and have remained unaltered for all the follow-up period. All the patients remain alive. Only seven patients have been readmitted to the hospital for non-myocardial related events. Group B only 11 patients continued alive to 5 years after surgery and LEVF never increased more than 6%, all of them with many hospitalizations (n ≥ 10) by heart failure events. Conclusion: Intramyocardial injection of CD34⁺ highly enriched PBSC represent an encouraging alternative for patients with severely scarred and dysfunctional myocardium.

Keywords

Stem Cells; Myocardial Infarction; CD34⁺ Cells; Revascularization; Heart Failure; Ventricular Function

Conflicts of Interest

The authors declare no conflicts of interest.

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