Autologous bone marrow-derived progenitor cell myocardial delivery for recent myocardial infarction patients following early angioplasty: results from a pilot study B,BB Maddury Jyotsna a, 4 , Geeta K. Vemuganti b , Purushottam Reddy b , K. Sarat Chandra a a Cardiology Department, Nizam’s Institute of Medical Sciences, Hyderabad, India b Stem Cell Laboratory, LV Prasad Eye Institute, Hyderabad, India Received 29 April 2006; accepted 28 June 2006 Abstract Purpose: Cellular cardiomyoplasty is a potential therapeutic approach to preventing left ventricular remodeling after myocardial infarction and has shown encouraging results such as induction of neoangiogenesis and functional improvement of diseased hearts. We report the results of a pilot study on progenitor cells in five patients with acute myocardial infarction (AMI). Materials and Methods: Patients with single-vessel disease who had their first episode of myocardial infarction and underwent angioplasty after 48 h (an average of 17 days following myocardial infarction) were included in the study. Mononuclear cells (MNCs) (1Â10 7 ) were isolated by Ficoll Hypaque method from 60 ml of bone marrow (BM) obtained from the iliac crest of 5 patients (aspiration was performed under local anesthesia). The mean CD34 count was 1–4%. After confirming the patency of the affected vessel postangioplasty, cellular concentrate was injected into the affected artery in 3-ml boluses (three to four injections), with intermittent occlusion. Results: The mean age of all five male patients was 48.6+13.7 years. At 1 year, five patients were asymptomatic, and one had Class II dyspnea on exertion. The results of an echocardiogram performed at 6 months showed an improvement in ejection fraction (EF) from 35.3% to 43.13% and in fractional shortening from 24.75% to 28.33%. End-systolic volume decreased from 115.5 to 92.3 ml, end-diastolic volume decreased from 177.5 to 170 ml, and end-systolic dimensions also decreased from 4.26 to 4 mm, demonstrating positive left ventricular remodeling. Repeat echocardiogram at 1 year showed persistent improvement in EF. No adverse events were noted either before or after the procedure. Conclusion: The injection of autologous BM MNCs is a safe and efficacious therapy following early revascularization in AMI patients. D 2006 Elsevier Inc. All rights reserved. Keywords: Mononuclear cells (MNCs); Ejection fraction (EF); Acute myocardial infarction (AMI) 1. Introduction Although prompt reperfusion within a narrow time window has significantly reduced mortality from acute myocardial infarction (AMI), post-AMI pathologic remod- eling and ensuing heart failure still remain major concerns and therapeutic challenges. A novel strategy that has been proposed to improve myocardial remodeling is autologous 1553-8389/06/$ – see front matter D 2006 Elsevier Inc. All rights reserved. doi:10.1016/j.carrev.2006.06.004 B This work was funded by the Nizam’s Institute of Medical Sciences (Hyderabad, India) and the LV Prasad Eye Institute. BB The authors do not have any commercial interest in any of the materials and methods used in this study. 4 Corresponding author. Cardiology Department, Nizam’s Institute of Medical Sciences, Punjagutta, Hyderabad, Andhra Pradesh, India. Tel.: +91 4027952277; fax: +91 4023310076. E-mail address: mail2jyotsna@rediffmail.com (M. Jyotsna). Cardiovascular Revascularization Medicine 7 (2006) 217 – 221