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| |  AHA: Infused Progenitor Cells Improve Cardiac Regeneration and Function After Acute Myocardial Infarction By Peggy Peck ORLANDO, FL -- November 10, 2003 -- Infusion of progenitor cells into infarct arteries within days of acute myocardial infarction significantly enhanced cardiac regeneration and cardiac function, according to results of a pilot study presented here at the American Heart Association's Scientific Sessions 2003. The cell transplants were associated with an increase in left ventricular ejection fraction (LVEF) from 49% to 58% and improved function in the infarct zone. Moreover, the greater the migratory capacity of the infused cells -- either blood-derived circulating progenitor cells (CPC) or bone marrow-derived cells (BMC) -- the greater the improvement in cardiac regeneration, said Birgit Assmus, MD, division of cardiology, University of Frankfurt, Frankfurt, Germany. "Migratory capacity was the only significant predictor of border contractility. Thus, it may be useful to explore ex vivo methods of improving migratory capacity," she said during a young investigators session here November 8th. Two-thirds of patients have completed 12-months of follow-up, and the results indicate that the improvements in LVEF are durable, she said. Follow-up assessments were done by echocardiogram and cardiac magnetic resonance imaging. Dr. Assmus explained that CPCs are attracted to vascular endothelial growth factor (VEGF) while BMCs migrate toward stromal cell-derived factor 1 (SDF-1), so the migratory capacity of cells was assessed in a Boyden chamber towards a gradient of VEGF for CPC and SDF-1 for BMC. "The migratory range for CPC was 10% to 50%, while for BMC the maximum was about 12%," she said. She noted that "statins can improve migratory capacity, so we used atorvastatin in the cell culture." The study randomized 30 patients to CPC infusion (17.0 x 106 CPCs) and 29 to BMC (219 x 106 BMCs). The mean age of the patients was 50. The cells were injected into the infarct artery distal to balloon inflation, she said. Infusion was done 3 to 5 days after the acute myocardial infarction. In addition to improved LVEF, patients had significant improvement in end systolic volumes (55 to 44 mL, P = .009) and a significant reduction in magnetic resonance imaging late enhancement volume (39 to 32 mL, P < .05). Dr. Assmus said the study, called Transplantation of Progenitor Cells and Regeneration Enhancement in Acute Myocardial Infarction (TOPCARE-AMI) was a pilot study, but a future study with a control arm is planned.
[Study title: Transplantation Of Progenitor Cells and Regeneration Enhancement in Acute Myocardial Infarction (TOPCARE-AMI): Migratory capacity of transplanted progenitor cells predicts functional improvement and infarct size reduction. Abstract 1470]
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