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Int J Med Sci 2020; 17(8):985-994. doi:10.7150/ijms.42561 This issue Cite

Research Paper

The Effect of Intracoronary Infusion of Autologous Bone Marrow-Derived Lineage-Negative Stem/Progenitor Cells on Remodeling of Post-Infarcted Heart in Patient with Acute Myocardial Infarction

Małgorzata Peregud-Pogorzelska^1*, Krzysztof Przybycień^1*, Bartłomiej Baumert², Maciej Kotowski², Ewa Pius-Sadowska², Krzysztof Safranow³, Jarosław Peregud-Pogorzelski⁴, Zdzisława Kornacewicz-Jach¹, Edyta Paczkowska^2✉, Bogusław Machaliński^2✉

1. Department of Cardiology, Pomeranian Medical University, Powstańców Wlkp. 72, 70-111 Szczecin, Poland
2. Department of General Pathology, Pomeranian Medical University, Powstańców Wlkp. 72, 70-111 Szczecin, Poland
3. Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Powstańców Wlkp. 72, 70-111 Szczecin, Poland
4. Department of Paediatric Oncology, Pomeranian Medical University, Unii Lub. 1, 71-252 Szczecin, Poland
* Authors contributed equally to this work

✉ Corresponding authors: Bogusław Machaliński, Department of General Pathology, Pomeranian Medical University in Szczecin, Al. Powstańców Wlkp. 72, 70-111 Szczecin, Poland. Tel. +4891 4661 546; Fax +4891 4661 548; E-mail: machalinedu.pl. Edyta Paczkowska, Department of General Pathology, Pomeranian Medical University in Szczecin, Al. Powstańców Wlkp. 72, 70-111 Szczecin, Poland. Tel. +4891 4661 546; Fax +4891 4661 548; E-mail: edyta.paczkowskaedu.pl More

Abstract

Introduction: Regenerative capacity of the heart is limited, and the post-infarct left ventricle (LV) dysfunction is associated with poor prognosis. Administration of stem/progenitor cells (SPCs) is a promising approach for cardiac regeneration.

Objectives: In the study, we assessed LV function and post-infarcted remodeling in patients with ST-elevated myocardial infarct (STEMI) who received autologous lineage-negative (LIN^-) SPCs.

Patients and methods: Patients with STEMI and one-vessel coronary artery disease treated with percutaneous revascularisation were divided into study group (LIN^- group, 15 patients) that received standard therapy and autologous BM-derived LIN^- SPCs and control group (standard therapy group, 19 patients). The cells were administered intracoronary 24 hours after STEMI. The follow-up was 12 months with subsequent non-invasive tests and laboratory parameter evaluation on days 1^st, 3^rd, and 7^th as well as at 1^st, 3^rd, 6^th and 12^th month after STEMI.

Results: All procedures related to SPCs administration were well tolerated by the patients. In 12-month follow-up, there were no major adverse cardiac events connected with LIN^- SPCs administration. During 12-month follow-up, 9 patients from LIN^- group (Responders) achieved an improvement in LV ejection fraction (>10% after 12 months) with no signs of unfavorable LV remodeling. Laboratory parameters analysis showed that Troponin T levels were significantly lower until day 7^th in the Responders group, while brain natriuretic peptide (BNP) level remained significantly lower from day 3^rd to 12^th month respectively.

Conclusions: Intracoronary infusion of autologous BM-derived LIN^- stem/progenitor cells is feasible and safe for patient. Improvement in LV function and prevention of unfavorable remodeling in the 60% of study group seems relatively promising. Stem cell-based therapy for cardiac regeneration still needs more accurate and extensive investigations to estimate and improve their efficacy.

Keywords: infarct, left ventricular failure, lineage-negative cells, remodeling, stem/progenitor cells

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