***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To evaluate the myocardial viability with (201)Tl/(18)F-FDG DISA-SPECT technique in patients with acute myocardial infa rct ion underwent emergent intracoronary autologous bone marrow mononuclear cells ( BM-MNC ) transplantation . METHODS Patients with first acute myocardial infa rct ion underwent emergent percutaneous coronary intervention ( PCI )  were r and omized in a 1:1 ratio to either intracoronary transplantation of autologous BM-MNC ( n = 20 ) or to sodium chloride concluding heparin ( control , n = 20 ) via a micro infusion catheter group immediately after PCI . Change in global left ventricular function ( LVEF measured by echocardiography ) and the myocardial viability detected by  (201)Tl/(18)F-FDG DISA-SPECT  from baseline and 6-months post transplantation were analyzed . RESULTS Left ventricular ejection fraction ( LVEF ) was improved in both groups and the absolute increase ( DeltaLVEF ) in BM-MNC group was significantly higher than that in control group ( 7.6 % + /- 2.8 % vs. 3.0 % + /- 2.8 % , P < 0.001 ) . In addition , the absolute decrease of myocardial infusion defect detected by (201)Tl SPECT was more significant in BM-MNC group than that in control group ( 6.7 % + /- 3.0 % vs. 2.6 % + /- 2.6 % , P < 0.001 ) and the number of mismatched segments ( indicating viable myocardium ) detected by (18)F-FDG SPECT in border zone was also significantly higher in BM-MNC group than that in control group . CONCLUSION Improved myocardial viability and reduced myocardial infusion defect post emergent intracoronary transplantation of autologous BM-MNC in patients with acute myocardial infa rct ion could be detected by (201)Tl/(18)F-FDG DISA-SPECT technique AIMS Intracoronary administration of autologous bone marrow cells ( BMC s ) leads to a modest improvement in cardiac function , but the effect on myocardial viability is unknown . The aim of this r and omized multicentre study was to evaluate the effect of BMC therapy on myocardial viability in patients with decreased left ventricular ejection fraction ( LVEF ) after acute myocardial infa rct ion ( AMI ) and to identify predictive factors for improvement of myocardial viability . METHODS AND RESULTS One hundred and one patients with AMI and successful reperfusion , LVEF ≤45 % , and decreased myocardial viability ( resting Tl201-SPECT ) were r and omized to either a control group ( n = 49 ) or a BMC group ( n = 52 ) . Primary endpoint was improvement of myocardial viability 3 months after AMI . Baseline mean LVEF measured by radionuclide angiography was 36.3 ± 6.9 % . Bone marrow cell infusion was performed 9.3 ± 1.7 days after AMI . Myocardial viability improved in 16/47 ( 34 % ) patients in the BMC group compared with 7/43 ( 16 % ) in the control group ( P = 0.06 ) . The number of non-viable segments becoming viable was 0.8 ± 1.1 in the control group and 1.2 ± 1.5 in the BMC group ( P = 0.13 ) . Multivariate analysis including major post-AMI prognostic factors showed a significant improvement of myocardial viability in BMC vs. control group ( P = 0.03 ) . Moreover , a significant adverse role for active smoking ( P = 0.04 ) and a positive trend for microvascular obstruction ( P = 0.07 ) were observed . CONCLUSION Intracoronary autologous BMC administration to patients with decreased LVEF after AMI was associated with improvement of myocardial viability in multivariate-but not in univariate- analysis . A large multicentre international trial is warranted to further document the efficacy of cardiac cell therapy and better define a group of patients that will benefit from this therapy . CLINICAL TRIAL REGISTRATION INFORMATION URL : http://www . clinical trials.gov . Unique identifier NCT00200707 Aims To evaluate the safety profile and efficacy of bone marrow mononuclear cells ( BMMNC ) transplantation for ST-segment elevation myocardial infa rct ion ( STEMI ) by assessing patients and their left ventricular function at up to 4 years follow-up . Methods and results Eighty-six patients with STEMI who had successfully undergone percutaneous coronary intervention ( PCI ) were r and omized to receive intracoronary injection of BMMNC ( n = 41 ) or saline ( n = 45 ) . Left ventricular ejection fraction , as evaluated by UCG , was markedly improved at 6 months ( 0.484 ± 0.5 vs. 0.457 ± 0.6 , P = 0.001 ) , 1 year ( 0.482 ± 0.7 vs. 0.446 ± 0.6 , P < 0.001 ) , and 4 years ( 0.505 ± 0.8 vs. 0.464 ± 0.8 , P < 0.001 ) after BMMNC transplant when compared with control group . However , the current cell therapy did not improve the myocardial viability of the infa rct ed area as assessed by single-photon emission computed tomography analysis at 4 years post-transplant ( 0.263 ± 0.007 in BMMNC group vs. 0.281 ± 0.008 in control group , P = 0.10 ) . During the follow-up period , one control group case ( 2.2 % ) of in-stent restenosis was confirmed by coronary angiography and underwent repeat PCI . Also during follow-up , one death ( 2.2 % ) occurred in the control group , and one patient ( 2.4 % ) in the BMMNC group had transient acute heart failure . Conclusion This study indicates that intracoronary delivery of autologous BMMNC is safe and feasible for STEMI patients who have undergone PCI , and can lead to long-term improvement in myocardial function Background — Intracoronary administration of autologous bone marrow – derived mononuclear cells ( BM-MNC ) may improve remodeling of the left ventricle ( LV ) after acute myocardial infa rct ion . The optimal time point of administration of BM-MNC is still uncertain and has rarely been addressed prospect ively in r and omized clinical trials . Methods and Results — In a multicenter study , we r and omized 200 patients with large , successfully reperfused ST-segment elevation myocardial infa rct ion in a 1:1:1 pattern into an open-labeled control and 2 BM-MNC treatment groups . In the BM-MNC groups , cells were administered either early ( ie , 5 to 7 days ) or late ( ie , 3 to 4 weeks ) after acute myocardial infa rct ion . Cardiac magnetic resonance imaging was performed at baseline and after 4 months . The primary end point was the change from baseline to 4 months in global LV ejection fraction between the 2 treatment groups and the control group . The absolute change in LV ejection fraction from baseline to 4 months was −0.4±8.8 % ( mean±SD ; P=0.74 versus baseline ) in the control group , 1.8±8.4 % ( P=0.12 versus baseline ) in the early group , and 0.8±7.6 % ( P=0.45 versus baseline ) in the late group . The treatment effect of BM-MNC  as estimated by ANCOVA was 1.25 ( 95 % confidence interval , −1.83 to 4.32 ; P=0.42 ) for the early therapy group and 0.55 ( 95 % confidence interval , −2.61 to 3.71 ; P=0.73 ) for the late therapy group . Conclusions — Among patients with ST-segment elevation myocardial infa rct ion and LV dysfunction after successful reperfusion , intracoronary infusion of BM-MNC at either 5 to 7 days or 3 to 4 weeks after acute myocardial infa rct ion did not improve LV function at 4-month follow-up . Clinical Trial Registration — URL : http://www . clinical trials.gov . Unique identifier : NCT00355186 AIMS R and omized trial to assess change in left ventricle ejection fraction ( LVEF ) and myocardial perfusion in patients with acute myocardial infa rct ion ( AMI ) of anterior wall treated with bone marrow stem cells ( BMSCs ) , compared with control group-from baseline in the acute phase up to 12 months of follow-up . METHODS AND RESULTS Forty-five patients were r and omized 2:1 to BMSC group ( n= 31 ) or to control group ( n = 14 ) .  Bone marrow stem cells were administered into infa rct -related artery ( IRA ) at 4 - 6 day after primary PCI . Groups were followed up with Tc-99m-MIBI SPECT , radionuclide ventriculography ( EF-RNV ) , echocardiography ( ECHO ) , and spiroergometric stress test . Coronary angiography was repeated after 6 months . EF-RNV did not differ significantly in both groups , but trend towards increase in EF at 6 months and its maintenance after 12 months was noticed in the BMSC group . At rest study , perfusion index ( PI ) of region supplied with blood by IRA distal to its previous occlusion ( PI-IRA ) improved significantly in the BMSC group at 6 months : PI-IRA at 4 - 6 days vs. PI-IRA at 6 months ( 3.00 + /- 0.97 vs. 2.65 + /- 0.64 ; P = 0.017 ) . At 12 months , PI-IRA at rest was 2.66 + /- 0.55 ; P = 0.07 . The difference between BMSC and control groups at rest study in PI-IRA was not observed . At dipyridamole study ( PI-dip ) , perfusion in the BMSC group was better compared with controls at 6 months ( 2.26 + /- 0.44 vs. 2.47 + /- 0.40 ; P = 0.033 ) and at 12 months ( 2.34 + /- 0.55 vs. 2.52 + /- 0.42 ; P = 0.014 ) , also for region supplied with blood by IRA ( PI-IRA-dip ; at 6 months 2.63 + /- 0.77 vs. 3.06 + /- 0.46 ; P = 0.021 and at 12 months 2.71 + /- 0.63 vs. 3.15 + /- 0.51 ; P = 0.001 ) . Results of LVEF , LVEDV , LVESV in ECHO and results of spiroergometric stress test did not differ significantly between groups . Major adverse cardiac events occurred more often in the control group ( P = 0.027 ) . CONCLUSION In our study , BMSC intracoronary transplantation in patients with anterior AMI did not result in increase in EF . Slight improvement of myocardial perfusion was noticed in the BMSC group . This finding may indicate better microcirculation enhanced by BMSCs , but small number of patients allow for hypothesis rather than final statement BACKGROUND Previous studies have shown improvement in left ventricular function after intracoronary injection of autologous cells derived from bone marrow ( BMC ) in the acute phase of myocardial infa rct ion . We design ed a r and omized , controlled trial to further investigate the effects of this treatment . METHODS Patients with acute ST-elevation myocardial infa rct ion of the anterior wall treated with percutaneous coronary intervention  were r and omly assigned to the group that underwent intracoronary injection of autologous mononuclear BMC or to the control group , in which neither aspiration nor sham injection was performed . Left ventricular function was assessed with the use of electrocardiogram-gated single-photon-emission computed tomography ( SPECT ) and echocardiography at baseline and magnetic resonance imaging ( MRI ) 2 to 3 weeks after the infa rct ion . These procedures were repeated 6 months after the infa rct ion . End points were changes in the left ventricular ejection fraction ( LVEF ) , end-diastolic volume , and infa rct size . RESULTS Of the 50 patients assigned to treatment with mononuclear BMC  , 47 underwent intracoronary injection of the cells at a median of 6 days after myocardial infa rct ion . There were 50 patients in the control group . The mean ( + /-SD ) change in LVEF , measured with the use of SPECT , between baseline and 6 months after infa rct ion for all patients was 7.6+/-10.4 percentage points . The effect of BMC treatment on the change in LVEF was an increase of 0.6 percentage point ( 95 % confidence 
    Output:
    
Overall , stem cell therapy is efficacious in the treatment of patients with STEMI , with low rates of adverse events compared with control group patients