PT  - JOURNAL ARTICLE
AU  - J van Ramshorst
AU  - D E Atsma
AU  - S L M A Beeres
AU  - S A Mollema
AU  - N Ajmone Marsan
AU  - E R Holman
AU  - E E van der Wall
AU  - M J Schalij
AU  - J J Bax
TI  - Effect of intramyocardial bone marrow cell injection on left ventricular dyssynchrony and global strain
AID  - 10.1136/hrt.2007.129569
DP  - 2009 Jan 15
TA  - Heart
PG  - 119--124
VI  - 95
IP  - 2
4099  - http://heart.bmj.com/content/95/2/119.short
4100  - http://heart.bmj.com/content/95/2/119.full
SO  - Heart2009 Jan 15; 95
AB  - Objective: To evaluate the effect of bone marrow cell injection on global strain and left ventricular (LV) dyssynchrony. Methods: In 14 patients with severe postinfarction heart failure, 93 (14)×106 autologous bone marrow cells were percutaneously injected in the infarction border zone. LV ejection fraction (LVEF), LV dyssynchrony and echocardiographic global strain were assessed at baseline and 3 months in patients and in a non-randomised control group of 10 patients with a history of infarction who developed heart failure and were treated medically. Results: No periprocedural complications occurred during bone marrow cell injection. At 3 months mean (SD) LVEF increased from 23 (8)% to 27 (9)% (p = 0.02) and global strain improved from −7.7 (4.7)% to −8.5 (4.9)% (p = 0.04). In patients with ⩾5% improvement in LVEF after bone marrow cell injection, global strain improved from −8.7 (4.6)% to −10.6 (4.5)% (p<0.01). Global strain remained unchanged in patients with <5% improvement in LVEF (−6.6 (4.9)% vs −6.4 (4.5)%, p = NS). The relation between the increase in LVEF and improvement in global strain was significant (r = 0.84, p<0.01). In patients with ⩾5% improvement in LVEF, LV dyssynchrony decreased from 173 (64) ms to 116 (64) ms (p = 0.01). In patients with <5% improvement in LVEF, LV dyssynchrony remained unchanged (155 (67) ms vs 177 (81) ms, p = NS). The correlation between improvement in LVEF and reduction in LV dyssynchrony was good (r = −0.77, p<0.01). In the control group, LVEF, global strain and LV dyssynchrony did not improve. Conclusions: Bone marrow cell injection improves LVEF in patients with severe postinfarction heart failure. The improvement in LVEF was related to reduced LV dyssynchrony and increased global strain.