Evidence that intracoronary-injected CD133+ peripheral blood progenitor cells home to the myocardium in chronic postinfarction heart failure

Objective To study the biodistribution of purified CD133+ cells after intracoronary injection in patients with stable chronic postinfarction heart failure. Patients and Methods Patients with longstanding myocardial infarction (>12 months prior to inclusion) and with an accessible left coronary artery were eligible. CD133+ cells were mobilized with granulocyte colony-stimulating factor and purified with a CliniMACS device. Cells were labeled with 111Indium and injected through a balloon catheter in a coronary artery feeding the necrotic or viable infarct-related region of the left ventricle during a standard coronary catheterization procedure. The total body biodistribution of 111Indium was studied with a dual-head gamma camera in combination with 99mTechnetium-sestaMIBI cardiac distribution analysis. Results The number of CD133+ cells injected ranged between 5 and 10 × 106 cells (low dose, three patients) or between 18.5 and 50 × 106 cells (high dose, five patients). In the five patients receiving the higher cell doses, a clear residual radioactivity was observed at the level of the chronic injury at 2, 12, and up to 36 hours after injection. A detailed analysis in two patients showed 6.9% to 8.0% (after 2 hours) and 2.3% to 3.2% (after 12 hours) residual radioactivity at the heart. No adverse events were observed during the procedure and up to 3 months follow-up. Conclusions We demonstrate that CD133+ progenitor cells are capable of homing to the postinfarction remodeling myocardium after intracoronary injections in patients with chronic postinfarction heart failure.