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May 19, 2009 -- Placing bone marrow cells directly into a heart that is lacking blood flow significantly improves angina symptoms, heart function, and a patient's quality of life, a study shows.

Jan van Ramshorst, MD, of Leiden University Medical Center in the Netherlands, and colleagues say bone marrow cell therapy may be a beneficial treatment for patients with chronic myocardial ischemia, a condition that results in long-term, reduced blood flow to certain areas of the heart.

Their study is published in the May 20 edition of The Journal of the American Medical Association.

The study included 50 patients, mostly men about 64 years old, whose symptoms did not respond to conventional treatments. At the start of the study, each participant underwent a procedure to have bone marrow removed from the hip. Then, the participants randomly received either eight bone marrow cell injections or a placebo solution directly into the affected heart muscle.

Three months later, tests to evaluate heart function and blood flow revealed that the participants who received the bone marrow cells had modest improvements in blood flow to the heart muscle and in overall heart function. Specifically, magnetic resonance imaging (MRI) of the heart showed that bone marrow cell therapy led to improvements in the left ventricle's ability to pump with each contraction. (This measurement is called left ventricular ejection fraction, or LVEF.)

Those who received the bone marrow cell injections also had:

* Better scores on quality-of-life tests three and six months later
* Improvements in the ability to exercise on a stationary bicycle

A handful of studies have also looked at the effect of bone marrow cell therapy in similar groups of patients and found the therapy to be "safe and feasible," according to background information in the journal report. Other, smaller studies evaluating the effect of this treatment on patients with ischemic heart disease have had varying results.

The current study is the first randomized, double-blind, placebo-controlled trial to link bone marrow cell therapy improvements in angina symptoms and left ventricle function with a "significant improvement" in the flow of blood to the heart muscle. It is not yet clear whether these improvements will translate into better survival for the treated patients.