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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
  1. Sung-A Chang (elisa99{at}medimail.co.kr)
  1. Seoul National University Hospital, Korea, Republic of
    1. Hyung-Kwan Kim (cardiman{at}medimail.co.kr)
    1. Seoul National University Hospital, Korea, Republic of
      1. Hae-Young Lee
      1. Seoul National University Hospital, Korea, Republic of
        1. Su-Yeon Choi
        1. Seoul National University Hospital, Korea, Republic of
          1. Bon-Kwon Koo
          1. Seoul National University Hospital, Korea, Republic of
            1. Yong-Jin Kim
            1. Seoul National University Hospital, Korea, Republic of
              1. Dae-Won Sohn
              1. Seoul National University Hospital, Korea, Republic of
                1. Byung-Hee Oh
                1. Seoul National University Hospital, Korea, Republic of
                  1. Young-Bae Park
                  1. Seoul National University Hospital, Korea, Republic of
                    1. Yun-Shik Choi
                    1. Seoul National University Hospital, Korea, Republic of
                      1. Hyun-Jae Kang
                      1. Seoul National University Hospital, Korea, Republic of
                        1. Hyo-Soo Kim (hyosoo{at}snu.ac.kr)
                        1. Seoul National University Hospital, Korea, Republic of

                          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 (ΔTs-SD: -45.0±40.2 vs. 5.0±39.9msec, P<0.001) and LVEF (ΔLVEF: 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, ΔTs-SD and baseline LVEF emerged as the independent determinant of LVEF improvement and cell infusion, and baseline Ts-SD as the determinant of ΔTs-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.

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