Long Term Efficacy Of Emergent Intracoronary Transplantation Of Bone Marrow Mononuclear Cells For Treatment Of Acute Myocardial Infarction

Objective To investigate the long term effects of emergent intracoronary autologous bone marrow mononuclear cell(BM-MNC) transplantation on left ventricular function and myocardium lesion area in patients with fist acute myocardial infarction. Methods Twenty patients admitted within 24hours after the onset of first AMI were randomly allocated to receive intracoronary autologous BMT(n=10)or bone marrow supermatant(con,n=10) immediately after primary percutaneous coronary intervention.Left ventricular ejection fraction(LVEF),left ventricular end-diastolic internal diameter(LVDd) and myocardial perfusion defect scores were examined by single photon emission computed tomography at 1 week and 6 months post AMI.Left ventricular ejection fraction(LVEF),left ventricular end-diastolic internal diameter (LVDd),myocardial radionuclide imaging and life quality were examined at 4years. Results After 4 years,2 patients withdraw in control group,2 patient did't have single photon emission computed tomography and echocardiography in experiment group. From 1 week to 6 months post AMI,LVEF was enhanced from 53.8%+9.2%to 58.6%±9.9%(P＜0.05) in the BMT group but unchanged in the CON group(58.2%±7.5%vs.56.3%±3.5%,P＞0.05);LVDd remained unchanged(51.3±2.5mm vs.52.1±.2mm,P＞0.05) in the BMT group but significantly enlarged in the CON group(50.4±6.0mm vs.55.2±7.1mm,P＜0.05).After 4years,LVEF was enhanced to 63.9±6.4%,largely increased compared with that in 6 months(P＜0.05),while unchanged in the CON group(56.8%±13.5%vs.56.3%±3.5%,P＞0.05)。After four years LVDd remained unchanged(51.3±2.5mmvs.52.1±3.2mm,P＞0.05) in the BMT group and also unchanged(56.0±7.3mm vs.55.2±7.1mm,P＞0.05) in the CON group。Additionally,myocardial perfusion defect scores were decreased from 21±11 to 13±10(P＜0.01) in the BMT group while unchanged in the CON group.After 4 years we didn't have this score,but myocardial radionuclide imaging show perfusion defect decreased after intracoronary transplantation of bone marrow mononuclear cells.After four years,the life quality didn't changed in this two groups. Conclusion Emergent intracoronary transplantation of autologous BM-MNC in patients with acute myocardial infarction improves the left ventricular function, prevent myocardial remodeling and increase myocardial perfusion at 4 years follow-up.