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Effect of Intramyocardial Injection of Autologous Bone Marrow–Derived Mononuclear Cells on Perfusion, Function, and Viability in Patients with Drug-Refractory Chronic Ischemia

Saskia L.M.A. Beeres, MD1, Jeroen J. Bax, MD, PhD1, Petra Dibbets2, Marcel P.M. Stokkel, MD, PhD2, Katja Zeppenfeld, MD, PhD1, Willem E. Fibbe, MD, PhD3, Ernst E. van der Wall, MD, PhD1, Martin J. Schalij, MD, PhD1 and Douwe E. Atsma, MD, PhD1

1 Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands; 2 Department of Nuclear Medicine, Leiden University Medical Center, Leiden, The Netherlands; and 3 Department of Hematology, Leiden, University Medical Center, Leiden, The Netherlands


Figure 1
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  		FIGURE 1.  SPECT images (vertical long axes) from representative patient. 99mTc-Tetrofosmin SPECT shows stress-induced ischemia at baseline in inferior wall (arrow). At 3-mo follow-up, ischemia in inferior wall has resolved. Metabolic imaging shows normal 18F-FDG uptake at baseline and 3-mo follow-up in that region, indicating no scar formation after intramyocardial injection of bone marrow–derived mononuclear cells.

 

Figure 2
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  		FIGURE 2.  Patients' segmental stress and rest scores improved significantly 3 mo after autologous bone marrow–derived mononuclear cell injection. Magnitude of increase in stress score was significantly higher as observed for rest score.

 

Figure 3
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  		FIGURE 3.  Patients' gated 99mTc-tetrofosmin SPECT segmental stress and rest scores in injected and noninjected segments. (A) Patients' segmental stress score improved in injected and noninjected segments. Improvement in injected segments was more pronounced than improvement in noninjected segments. (B) There was a trend toward improvement in rest score in injected and noninjected segments. Magnitude of improvement in rest score was similar in injected and noninjected segments.

 




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