A 62-year-old male patient with previous history of myocardial infarction, akinetic myocardial segments, and an ejection fraction of 31% with the NYHA class III category was selected for the autologous bone marrow (ABM)-derived mononclear cell fraction during CABG surgery. Nitrate augmented myocardial tracer uptake was imaged by ECG gated SPECT pre-and 1 year post-ABM therapy, using radiotracer Tc99m Sestamibi. The baseline gated SPECT demonstrated full thickness infarct 40% area of LAD territory. Bone marrow aspirate of 20.0 ml of sterline mormal saline yielding a mono nuclear cell fraction of 4.5x107 cells/ml was suspended in 2.0ml of sterile normal saline to be injected at eight sites of the injured myocardium. There were no apparent side effects due to the procedure,i.e., life threatening events,major bleeds, reaction, or shock.The case was followed at the end of 1,3,6 months by ECG and monitor and ECG gated SPECT at the end of 12 months. The gated SPECT image demonstrated mild but definitely improved tracer uptake within part of the infracted segments along with improvement in ejection fraction to 45%, and a clinical change in the NYHA Class to II. Cell-based therapy may offer benefits of induction of normal tissue microenvironment.
Key words: Autologous bone marrow mononuclear therapy, cardiovascular disease research,myocardial infraction, molecular imaging.