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Administration of intracoronary bone marrow mononuclear cells on chronic myocardial infarction improves diastolic function
  1. Kang Yao (yao.kang{at}zs-hospital.sh.cn)
  1. Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute, China
    1. Rongchong Huang
    1. Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
      1. Juying Qian
      1. Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute, China
        1. Jie Cui
        1. Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute, China
          1. Lei Ge
          1. Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute, China
            1. Yanlin Li
            1. Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute, China
              1. Feng Zhang
              1. Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute, China
                1. Hongyu Shi
                1. Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute, China
                  1. Dong Huang
                  1. Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute, China
                    1. Shuning Zhang
                    1. Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute, China
                      1. Aijun Sun
                      1. Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute, China
                        1. Yunzeng Zou
                        1. Department of Cardiology, Zhongshan Hospital, Fudan University, China
                          1. Junbo Ge (ge.junbo2{at}zs-hospital.sh.cn)
                          1. Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute, China

                            Abstract

                            Background Regeneration of the myocardium and improved ventricular function have been demonstrated in patients with acute myocardial infarction (MI) treated by intracoronary delivery of autologous bone marrow mononuclear cells (BMC) a few days after successful myocardial reperfusion by percutaneous coronary intervention (PCI); however, the effects of intracoronary cell infusion in chronic MI patients are still unknown.

                            Aims The purpose of the present study was to investigate whether intracoronary infusion of BMC into the infarct-related artery in patients with healed MI could lead to improvement in left ventricular (LV) function.

                            Methods Among 47 patients with stable ischemic heart disease due to a previous MI (13±8 months previously), 24 were randomized to intracoronary infusion of BMC (BMC group) and 23 to a saline infusion (CON group) into the target vessel after successful PCI within 12 hours after chest pain occurred. LV systolic and diastolic function, infarct size, and myocardial perfusion defect were assessed with the use of echocardiography, magnetic resonance imaging (MRI), or 201Tl single-photon-emission computed tomography (SPECT) at baseline and repeated at the 6 month follow-up examination.

                            Results BMC treatment did not result in a significant increase in LV ejection fraction in any of the groups by any of the methods used, and the apparent tendency of an improvement was not statistically different between the two groups. The two groups also did not differ significantly in changes of LV end-diastolic and systolic volume, infarct size, or myocardial perfusion. However, there was an overall effect of BMC transfer compared with the control group with respect to E/A (P<0.001), Ea/Aa ratio (P=0.002), and IVRT (P=0.038) after 6 months, as evaluated by tissue Doppler echocardiography . We noted no complications associated with BMS transfer.

                            Conclusions Intracoronary transfer of autologous BMC in patients with healed MI did not lead to significant improvement of cardiac systolic function, infarct size, and myocardial perfusion, but did lead to improvement in diastolic function.

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