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Blood-derived progenitor cells after recanalization of chronic coronary artery occlusions in humans.

See related article, pages 756–762 

The first studies to treat patients with acute ST segment elevation myocardial infarction were by Strauer et al and Zeiher et al.1,2 In these studies, percutaneous transluminal coronary angioplasty (PTCA) was used to open the infarct related artery, and bone marrow-derived mononuclear cells or circulating endothelial progenitor cells were injected into the infarct-related arteries.1,2 The cell-based therapy in these 2 initial studies improved coronary blood flow and segmental left ventricular (LV) function in the treated regions. Wollert et al subsequently reproduced the earlier findings in a blinded randomized study, again in patients with acute ST segment elevation myocardial infarcts (MIs).3 These 3 studies were the first to treat patients with acute ST segment elevation MIs after PTCA with cell-based therapy, and each used intracoronary injections in patients who did not have severe heart failure.

At the same time that Strauer et al and Zeiher et al were performing their initial studies in Germany (2000–2002), Texas Heart Institute cardiologists, Drs Perin and Willerson and Brazilian cardiologists led by Dr Dohmann in Rio de Janeiro, Brazil, were treating patients with chronic coronary heart disease, prior myocardial infarction, and severe heart failure with transendocardial injections of bone marrow-derived mononuclear cells using electromechanical mapping to identify sites of reversible myocardial injury.4 This was the initial study in the world done with cell-based therapy for patients with severe heart failure with direct transendocardial injections of bone marrow-derived mononuclear cells …