***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: The aim of the study was to investigate whether a combination of mesenchymal stem cells ( MSCs ) capable of differentiating into cardiac myocytes and endothelial progenitors ( EPCs ) that mainly promote neoangiogenesis might be able to facilitate tissue repair in myocardial scars . Previous studies have shown that intracoronary transplantation of autologous bone marrow stem cells results in improvement of contractility in infracted areas of human myocardium . Eleven patients with an anteroseptal myocardial infa rct ion ( MI ) underwent transcoronary transplantation of bone marrow‐derived MSCs and EPCs to the infa rct ed area through the left anterior descending artery . Eleven age‐ and sex‐matched patients served as controls . Wall motion score index was significantly lower at follow‐up in the transplantation ( P = 0.04 ) but not in the control group . On stress echocardiography , there was improvement of myocardial contractility in one or more previously nonviable myocardial segments in 5 out of 11 patients ( all with recent infa rct ions ) and in none of the controls ( P = 0.01 ) . Restoration of uptake of Tc99 m sestamibi in one or more previously nonviable myocardial scars was seen in 6 out of 11 patients subjected to transplantation and in none of the controls ( P = 0.02 ) . Cell transplantation was an independent predictor of improvement of nonviable tissue . Intracoronary transplantation of MSCs and EPCs is feasible , safe , and may contribute to regional regeneration of myocardial tissue early or late following MI . © 2005 Wiley‐Liss , Background —We recently reported the safety and feasibility of autologous bone marrow mononuclear cell ( ABMMNC ) injection into areas of ischemic myocardium in patients with end-stage ischemic cardiomyopathy . The present study evaluated the safety and efficacy of this therapy at 6- and 12-month follow-up . Methods and Results —Twenty patients with 6- and 12-month follow-up ( 11 treated subjects ; 9 controls ) were enrolled in this prospect i ve , nonr and omized , open-label study . Complete clinical and laboratory evaluations as well as exercise stress ( ramp treadmill ) , 2-dimensional Doppler echocardiography , single-photon emission computed tomography ( SPECT ) perfusion scanning , and 24-hour Holter monitoring were performed at baseline and follow-up . Transendocardial delivery of ABMMNCs was performed with the aid of electromechanical mapping to identify viable myocardium . Each patient received 15 ABMMNC injections of 0.2 mL each . At 6 and 12 months , total reversible defect , as measured by SPECT perfusion scanning , was significantly reduced in the treatment group as compared with the control group . At 12 months , exercise capacity was significantly improved in the treatment group . This improvement correlated well with monocyte , B-cell , hematopoietic progenitor cell , and early hemapoietic progenitor cell phenotypes . Conclusions —The 6- and 12-month follow-up data in this study suggest that transendocardial injection of ABMMNCs in patients with end-stage ischemic heart disease may produce a durable therapeutic effect and improve myocardial perfusion and exercise capacity Background — Intracoronary transfer of autologous bone marrow cells ( BMC s ) may enhance recovery of left ventricular ( LV ) function in patients after acute myocardial infa rct ion ( AMI ) . However , clinical studies addressing the effects of BMC s after AMI have covered only limited time frames ranging from 3 to 6 months . The critical question of whether BMC transfer can have a sustained impact on LV function remains unanswered . Methods and Results – After percutaneous coronary intervention with stent implantation ( PCI ) of the infa rct -related artery , 60 patients were r and omized 1:1 to a control group with optimal postinfa rct ion therapy and a BMC transfer group that also received an intracoronary BMC infusion 4.8±1.3 days after PCI . Cardiac MRI was performed 3.5±1.5 days , 6±1 months , and 18±6 months after PCI . BMC transfer was not associated with adverse clinical events . In the control group , mean global LV ejection fraction increased by 0.7 and 3.1 percentage points after 6 and 18 months , respectively . LV ejection fraction in the BMC transfer group increased by 6.7 and 5.9 percentage points . The difference in LVEF improvement between groups was significant after 6 months but not after 18 months ( P=0.27 ) . The speed of LV ejection fraction recovery over the course of 18 months was significantly higher in the BMC transfer group ( P=0.001 ) . Conclusions – In this study , a single dose of intracoronary BMC s did not provide long-term benefit on LV systolic function after AMI compared with a r and omized control group ; however , the study suggests an acceleration of LV ejection fraction recovery after AMI by BMC therapy 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 interval [ CI ] , -3.4 to 4.6 ; P=0.77 ) on SPECT , an increase of 0.6 percentage point ( 95 % CI , -2.6 to 3.8 ; P=0.70 ) on echocardiography , and a decrease of 3.0 percentage points ( 95 % CI , 0.1 to -6.1 ; P=0.054 ) on MRI . The two groups did not differ significantly in changes in left ventricular end-diastolic volume or infa rct size and had similar rates of adverse events . CONCLUSIONS With the methods used , we found no effects of intracoronary injection of autologous mononuclear BMC on global left ventricular function Background — Recent trials have shown that intracoronary infusion of bone marrow cells ( BMC s ) improves functional recovery after acute myocardial infa rct ion . However , whether this treatment is effective in heart failure as a consequence of remodeling after organized infa rcts remains unclear . In this r and omized trial , we assessed the hypothesis that direct intramyocardial injection of autologous mononuclear bone marrow cells during coronary artery bypass graft ( CABG ) could improve global and regional left ventricular ejection fraction ( LVEF ) at 4-month follow-up . Methods and Results — Twenty patients ( age 64.8±8.7 ; 17 male , 3 female ) with a postinfa rct ion nonviable scar , as assessed by thallium ( Tl ) scintigraphy and cardiac magnetic resonance imaging ( MRI ) , scheduled for elective CABG , were included . They were r and omized to a control group ( n = 10 , CABG only ) or a BMC group ( CABG and injection of 60.106±31.106 BMC ) . Primary end points were global LVEF change and wall thickening changes in the infa rct area from baseline to 4-month follow-up , as measured by MRI . Changes in metabolic activity were measured by Tl scintigraphy and expressed as a score with a range from 0 to 4 , corresponding to percent of maximal myocardial Tl uptake ( 4 indicates < 50 % , nonviable scar ; 3 , 50 % to 60 % ; 2 , 60 % to 70 % ; 1 , 70 % to 80 % ; 0>80 % ) . Global LVEF at baseline was 39.5±5.5 % in controls and 42.9±10.3 % in the BMC group ( P=0.38 ) . At 4 months , LVEF had increased to 43.1±10.9 % in the control group and to 48.9±9.5 % in the BMC group ( P=0.23 ) . Systolic thickening had improved from −0.6±1.3 mm at baseline to 1.8±2.6 mm at 4 months in the cell-implanted scars , whereas nontreated scars remained largely akinetic ( −0.5±2.0 mm at baseline compared with 0.4±1.7 mm at 4 months , P=0.007 control versus BMC -treated group at 4 months ) . Defect score decreased from 4 to 3.3±0.9 in the BMC group and to 3.7±0.4 in the control group ( P=0.18 ) . Conclusions — At 4 months , there was no significant difference in global LVEF between both groups , but a recovery of regional contractile function in previously nonviable scar was observed in the BMC group Background —Intracoronary transfer of autologous bone marrow cells ( BMC s ) promotes recovery of left ventricular systolic function in patients with acute myocardial infa rct ion . Although the mechanisms of this effect remain to be established , homing of BMC s into the infa rct ed myocardium is probably a critical early event . Methods and Results —We determined BMC biodistribution after therapeutic application in patients with a first ST-segment – elevation myocardial infa rct ion who had undergone stenting of the infa rct -related artery . Unselected BMC s were radiolabeled with 100 MBq 2-[18F]-fluoro-2-deoxy-d-glucose ( 18F-FDG ) and infused into the infa rct -related coronary artery ( intracoronary ; n=3 patients ) or injected via an antecubital vein ( intravenous ; n=3 patients ) . In 3 additional patients , CD34-positive ( CD34 + ) cells were immunomagnetically enriched from unselected BMC s , labeled with 18F-FDG , and infused intracoronarily . Cell transfer was performed 5 to 10 days after stenting . More than 99 % of the infused total radioactivity was cell bound . Nucleated cell viability , comparable in all preparations , ranged from 92 % to 96 % . Fifty to 75 minutes after cell transfer , all patients underwent 3D PET imaging . After intracoronary transfer , 1.3 % to 2.6 % of 18F-FDG – labeled unselected BMC s were detected in the infa rct ed myocardium ; the remaining activity was found primarily in liver and spleen . After intravenous transfer , only background activity was detected in the infa rct ed myocardium . After intracoronary transfer of 18F-FDG – labeled CD34-enriched cells , 14 % to 39 % of the total activity was detected in the infa rct ed myocardium . Unselected BMC s engrafted in the infa rct center and border zone ; homing of CD34-enriched cells was more pronounced in the border zone . Conclusions —18F-FDG labeling and 3D PET imaging can be used to monitor myocardial homing and biodistribution of BMC s after therapeutic application in patients Background —Bone marrow CD133-postive ( CD133 + ) cells possess high hematopoietic and angiogenic capacity . We tested the feasibility , safety , and functional effects of the use of enriched CD133 + progenitor cells after intracoronary administration in patients with recent myocardial infa rct ion . Methods and Results —Among 35 patients with acute myocardial infa rct ion treated with stenting , 19 underwent intracoronary administration of CD133 + progenitor cells ( 12.6±2.2 × 106 cells ) 11.6±1.4 days later ( group 1 ) and 16 did not ( group 2 ) . At 4 months , left ventricular ejection fraction increased significantly in group 1 ( from 45.0±2.6 % to 52.1±3.5 % , P<0.05 ) , but only tended to increase in case-matched group 2 patients ( from 44.3±3.1 % to 48.6±3.6 % , P 
    Output:
    
The available evidence suggests that BMC transplantation is associated with modest improvements in physiologic and anatomic parameters in patients with both acute myocardial infa rct ion and chronic ischemic heart disease , above and beyond conventional therapy .
Therapy with BMC s seems safe .