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Circulation. 2002
Published online before print September 3, 2002, doi: 10.1161/01.CIR.0000034046.87607.1C
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Submitted on August 2, 2002
Accepted on August 2, 2002

Repair of Infarcted Myocardium by Autologous Intracoronary Mononuclear Bone Marrow Cell Transplantation in Humans

Bodo E. Strauer MD*, Michael Brehm MD, Tobias Zeus MD, Matthias Köstering MD, Anna Hernandez PhD, Rüdiger V. Sorg PhD, Gesine Kögler PhD, and Peter Wernet MD

From the Department of Medicine, Division of Cardiology (B.E.S., M.B., T.Z., M.K.) and Institute for Transplantation Diagnostics and Cell Therapeutics (A.H., R.V.S., G.K., P.W.), Heinrich-Heine-University of Düsseldorf, Germany.

* To whom correspondence should be addressed. E-mail: Strauer{at}med.uni-duesseldorf.de.

Background—Experimental data suggest that bone marrow-derived cells may contribute to the healing of myocardial infarction (MI). For this reason, we analyzed 10 patients who were treated by intracoronary transplantation of autologous, mononuclear bone marrow cells (BMCs) in addition to standard therapy after MI.

Methods and Results—After standard therapy for acute MI, 10 patients were transplanted with autologous mononuclear BMCs via a balloon catheter placed into the infarct-related artery during balloon dilatation (percutaneous transluminal coronary angioplasty). Another 10 patients with acute MI were treated by standard therapy alone. After 3 months of follow-up, the infarct region (determined by left ventriculography) had decreased significantly within the cell therapy group (from 30±13 to 12±7%, P=0.005) and was also significantly smaller compared with the standard therapy group (P=0.04). Likewise, infarction wall movement velocity increased significantly only in the cell therapy group (from 2.0±1.1 to 4.0±2.6 cm/s, P=0.028). Further cardiac examinations (dobutamine stress echocardiography, radionuclide ventriculography, and catheterization of the right heart) were performed for the cell therapy group and showed significant improvement in stroke volume index, left ventricular end-systolic volume and contractility (ratio of systolic pressure and end-systolic volume), and myocardial perfusion of the infarct region.

Conclusions—These results demonstrate for the first time that selective intracoronary transplantation of autologous, mononuclear BMCs is safe and seems to be effective under clinical conditions. The marked therapeutic effect may be attributed to BMC-associated myocardial regeneration and neovascularization.


Key words: myocardial infarction • cell transplantation, intracoronary • angiogenesis • bone marrow • myogenesis




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J. Nussbaum, E. Minami, M. A. Laflamme, J. A. I. Virag, C. B. Ware, A. Masino, V. Muskheli, L. Pabon, H. Reinecke, and C. E. Murry
Transplantation of undifferentiated murine embryonic stem cells in the heart: teratoma formation and immune response
FASEB J, May 1, 2007; 21(7): 1345 - 1357.
[Abstract] [Full Text] [PDF]


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CirculationHome page
S. Fukushima, A. Varela-Carver, S. R. Coppen, K. Yamahara, L. E. Felkin, J. Lee, P. J.R. Barton, C. M.N. Terracciano, M. H. Yacoub, and K. Suzuki
Direct Intramyocardial But Not Intracoronary Injection of Bone Marrow Cells Induces Ventricular Arrhythmias in a Rat Chronic Ischemic Heart Failure Model
Circulation, May 1, 2007; 115(17): 2254 - 2261.
[Abstract] [Full Text] [PDF]


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Circ. Res.Home page
V. L.T. Ballard and J. M. Edelberg
Stem Cells and the Regeneration of the Aging Cardiovascular System
Circ. Res., April 27, 2007; 100(8): 1116 - 1127.
[Abstract] [Full Text] [PDF]


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BloodHome page
D. J. Prockop and S. D. Olson
Clinical trials with adult stem/progenitor cells for tissue repair: let's not overlook some essential precautions
Blood, April 15, 2007; 109(8): 3147 - 3151.
[Full Text] [PDF]


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J Am Coll CardiolHome page
X.-X. Wang, F.-R. Zhang, Y.-P. Shang, J.-H. Zhu, X.-D. Xie, Q.-M. Tao, J.-H. Zhu, and J.-Z. Chen
Transplantation of Autologous Endothelial Progenitor Cells May Be Beneficial in Patients With Idiopathic Pulmonary Arterial Hypertension: A Pilot Randomized Controlled Trial
J. Am. Coll. Cardiol., April 10, 2007; 49(14): 1566 - 1571.
[Abstract] [Full Text] [PDF]


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J Am Coll CardiolHome page
S. L.M.A. Beeres, F. M. Bengel, J. Bartunek, D. E. Atsma, J. M. Hill, M. Vanderheyden, M. Penicka, M. J. Schalij, W. Wijns, and J. J. Bax
Role of Imaging in Cardiac Stem Cell Therapy
J. Am. Coll. Cardiol., March 20, 2007; 49(11): 1137 - 1148.
[Abstract] [Full Text] [PDF]


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Cardiovasc ResHome page
S. Vandervelde, M. J.A. van Luyn, M. H. Rozenbaum, A. H. Petersen, R. A. Tio, and M. C. Harmsen
Stem cell-related cardiac gene expression early after murine myocardial infarction
Cardiovasc Res, March 1, 2007; 73(4): 783 - 793.
[Abstract] [Full Text] [PDF]


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Circ. Res.Home page
B. A. Pallante, I. Duignan, D. Okin, A. Chin, M. C. Bressan, T. Mikawa, and J. M. Edelberg
Bone Marrow Oct3/4+ Cells Differentiate Into Cardiac Myocytes via Age-Dependent Paracrine Mechanisms
Circ. Res., January 5, 2007; 100(1): e1 - e11.
[Abstract] [Full Text] [PDF]


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CirculationHome page
A. Aicher, C. Heeschen, K.-i. Sasaki, C. Urbich, A. M. Zeiher, and S. Dimmeler
Low-Energy Shock Wave for Enhancing Recruitment of Endothelial Progenitor Cells: A New Modality to Increase Efficacy of Cell Therapy in Chronic Hind Limb Ischemia
Circulation, December 19, 2006; 114(25): 2823 - 2830.
[Abstract] [Full Text] [PDF]


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CirculationHome page
S. T. Wall, J. C. Walker, K. E. Healy, M. B. Ratcliffe, and J. M. Guccione
Theoretical Impact of the Injection of Material Into the Myocardium: A Finite Element Model Simulation
Circulation, December 12, 2006; 114(24): 2627 - 2635.
[Abstract] [Full Text] [PDF]


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HeartHome page
M Saha, R Zbinden, S R Redwood, and M S Marber
Stem cells to repair the broken heart: much ado about nothing?
Heart, December 1, 2006; 92(12): 1717 - 1719.
[Abstract] [Full Text] [PDF]


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J Am Coll CardiolHome page
S. Seth, R. Narang, B. Bhargava, R. Ray, S. Mohanty, G. Gulati, L. Kumar, K. S. Reddy, P. Venugopal, and AIIMS Cardiovascular Stem Cell Study Group
Percutaneous Intracoronary Cellular Cardiomyoplasty for Nonischemic Cardiomyopathy: Clinical and Histopathological Results: The First-in-Man ABCD (Autologous Bone Marrow Cells in Dilated Cardiomyopathy) Trial
J. Am. Coll. Cardiol., November 10, 2006; (2006) j.jacc.2006.07.057v1.
[Full Text] [PDF]


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J. Thorac. Cardiovasc. Surg.Home page
C. Kubal, K. Sheth, B. Nadal-Ginard, and M. Galinanes
Bone marrow cells have a potent anti-ischemic effect against myocardial cell death in humans.
J. Thorac. Cardiovasc. Surg., November 1, 2006; 132(5): 1112 - 1118.
[Abstract] [Full Text] [PDF]


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CirculationHome page
M. R. Rosen
Are Stem Cells Drugs?: The Regulation of Stem Cell Research and Development
Circulation, October 31, 2006; 114(18): 1992 - 2000.
[Abstract] [Full Text] [PDF]


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J Am Coll CardiolHome page
I. Ben-Dor, S. Fuchs, and R. Kornowski
Potential Hazards and Technical Considerations Associated With Myocardial Cell Transplantation Protocols for Ischemic Myocardial Syndrome
J. Am. Coll. Cardiol., October 17, 2006; 48(8): 1519 - 1526.
[Abstract] [Full Text] [PDF]


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J Am Coll CardiolHome page
H. Guven, R. M. Shepherd, R. G. Bach, B. J. Capoccia, and D. C. Link
The Number of Endothelial Progenitor Cell Colonies in the Blood Is Increased in Patients With Angiographically Significant Coronary Artery Disease
J. Am. Coll. Cardiol., October 17, 2006; 48(8): 1579 - 1587.
[Abstract] [Full Text] [PDF]


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J. Thorac. Cardiovasc. Surg.Home page
H. Hata, G. Matsumiya, S. Miyagawa, H. Kondoh, N. Kawaguchi, N. Matsuura, T. Shimizu, T. Okano, H. Matsuda, and Y. Sawa
Grafted skeletal myoblast sheets attenuate myocardial remodeling in pacing-induced canine heart failure model
J. Thorac. Cardiovasc. Surg., October 1, 2006; 132(4): 918 - 924.
[Abstract] [Full Text] [PDF]


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Ann. Thorac. Surg.Home page
K.-L. Ang, L. Takura Shenje, L. Srinivasan, and M. Galinanes
Repair of the damaged heart by bone marrow cells: from experimental evidence to clinical hope.
Ann. Thorac. Surg., October 1, 2006; 82(4): 1549 - 1558.
[Abstract] [Full Text] [PDF]


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Eur J Heart FailHome page
S. Roura, J. Farre, C. Soler-Botija, A. Llach, L. Hove-Madsen, J. J. Cairo, F. Godia, J. Cinca, and A. Bayes-Genis
Effect of aging on the pluripotential capacity of human CD105+ mesenchymal stem cells
Eur J Heart Fail, October 1, 2006; 8(6): 555 - 563.
[Abstract] [Full Text] [PDF]


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Arterioscler. Thromb. Vasc. Bio.Home page
J. Honold, R. Lehmann, C. Heeschen, D. H. Walter, B. Assmus, K.-I. Sasaki, H. Martin, J. Haendeler, A. M. Zeiher, and S. Dimmeler
Effects of Granulocyte Colony Stimulating Factor on Functional Activities of Endothelial Progenitor Cells in Patients With Chronic Ischemic Heart Disease
Arterioscler Thromb Vasc Biol, October 1, 2006; 26(10): 2238 - 2243.
[Abstract] [Full Text] [PDF]


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NEJMHome page
K. Lunde, S. Solheim, S. Aakhus, H. Arnesen, M. Abdelnoor, T. Egeland, K. Endresen, A. Ilebekk, A. Mangschau, J. G. Fjeld, et al.
Intracoronary injection of mononuclear bone marrow cells in acute myocardial infarction.
N. Engl. J. Med., September 21, 2006; 355(12): 1199 - 1209.
[Abstract] [Full Text] [PDF]