Leiden University Scholarly Publications

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Ramshorst, J. van (2014)

Intramyocardial Bone Marrow Cell Injection: Clinical and Functional Effects in Ischemic Heart Disease

Doctoral Thesis
Coronary artery disease is a major cause of mortality and morbidity in the western world. Despite successive revascularization procedures, a large number of patients ends up with end-stage coronary artery disease, not amenable for conventional revascularization. These patients often have stress-inducible myocardial ischemia, resulting in disabling complaints of angina, refractory to medical treatment. Intramyocardial bone marrow cell injection is currently under investigation as a new therapeutic option for these patients. This treatment aims to improve myocardial perfusion and contractile function (and decrease anginal complaints) through administration of bone marrow cells into ischemic myocardium. In the current thesis, the use of intramyocardial bone marrow cell injection for the treatment of chronic myocardial ischemia is evaluated several studies. First, the results of a randomized, placebo controlled, double-blinded trial are described, demonstrating that bone marrow cell...Show moreCoronary artery disease is a major cause of mortality and morbidity in the western world. Despite successive revascularization procedures, a large number of patients ends up with end-stage coronary artery disease, not amenable for conventional revascularization. These patients often have stress-inducible myocardial ischemia, resulting in disabling complaints of angina, refractory to medical treatment. Intramyocardial bone marrow cell injection is currently under investigation as a new therapeutic option for these patients. This treatment aims to improve myocardial perfusion and contractile function (and decrease anginal complaints) through administration of bone marrow cells into ischemic myocardium. In the current thesis, the use of intramyocardial bone marrow cell injection for the treatment of chronic myocardial ischemia is evaluated several studies. First, the results of a randomized, placebo controlled, double-blinded trial are described, demonstrating that bone marrow cell injection is associated with a reduction in angina complaints, improved myocardial perfusion and increased left ventricular function. Furthermore, the effects of intramyocardial bone marrow cell injection were further explored by evaluating changes in diastolic function, cardiac innervation, and left ventricular synchronicity. In addition, the long term effects of bone marrow cell injection are described.Show less
Diastolic function
Myocardial innervation
Bone marrow mononuclear cells
Myocardial ischemia
Coronary artery disease
Cell therapy
All authors
Ramshorst, J. van
Supervisor
Schalij, M.J.
Co-supervisor
Atsma, D.E.
Qualification
Doctor (dr.)
Awarding Institution
Faculty of Medicine (LUMC), Leiden University
Date
2014-04-02
ISBN (print)
9789461086259

Funding

Sponsorship
Financial support by Abbott Vascular, Chipsoft BV, Orbus International BV, Medis medical Imaging systems BV and Biosense Webster Inc. (a Johnson and Johnson Medical Company) for the publication of this thesis is gratefully acknowledged