Restoration of the left ventricular synchronous contraction after acute myocardial infarction by stem cell therapy: new insights into the therapeutic implication of stem cell therapy for acute myocardial infarction

Sung-A Chang ¹, Hyung-Kwan Kim ¹, Hae-Young Lee ¹, Su-Yeon Choi ¹, Bon-Kwon Koo ¹, Yong-Jin Kim ¹, Dae-Won Sohn ¹, Byung-Hee Oh ¹, Young-Bae Park ¹, Yun-Shik Choi ¹, Hyun-Jae Kang ¹ and Hyo-Soo Kim ^1*

¹ Seoul National University Hospital, Korea, Republic of

^* To whom correspondence should be addressed. E-mail: hyosoo{at}snu.ac.kr.

Accepted 4 September 2007

Abstract

Objective To evaluate the effects of stem cell therapy on restoration of the left ventricular (LV) synchronous contraction in patients with acute myocardial infarction (AMI).

Methods 40 patients with AMI who underwent successful coronary revascularization were randomly allocated to the cell infusion or the control group. Evaluations were performed with echocardiographic tissue synchronization imaging to determine LV dyssynchrony and with cardiac magnetic resonance imaging to estimate LV ejection fraction (LVEF) at baseline and at 6 months. To quantify the severity of systolic LV dyssynchrony, the standard deviations of time to peak systolic velocity of the 12 LV segments (Ts-SD) were calculated.

Results At 6 months, greater improvements of Ts-SD (Ts-SD: -45.0±40.2 vs. 5.0±39.9msec, P<0.001) and LVEF (LVEF: 6.8±9.1 vs. -0.2±6.9%, P=0.015) relative to the corresponding baseline values were observed in the cell infusion group than in the control group. By multivariate analysis, Ts-SD and baseline LVEF emerged as the independent determinant of LVEF improvement and cell infusion, and baseline Ts-SD as the determinant of Ts-SD improvement. Maximal exercise capacity measured by symptom-limited treadmill testing correlated well with Ts-SD but not with LVEF at 6 months of follow-up.

Conclusion Stem cell therapy had a favorable effect on the restoration of LV synchronous contraction in patients with AMI.

Keywords: Acute myocardial infarction, Dyssynchrony, Echocardiography, Peripheral blood stem cell transplantation

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