title: Exercise capacity and quality of life after intracoronary injection of autologous mononuclear bone marrow cells in acute myocardial infarction: results from the Autologous Stem cell Transplantation in Acute Myocardial Infarction (ASTAMI) randomized controlled trial.
abstract: BACKGROUND
  The effects on left ventricular function of intracoronary injection of bone marrow cells in acute myocardial infarction (AMI) have been studied with conflicting results. The aim of this substudy of the ASTAMI trial was to examine the effects of this novel treatment on exercise capacity and quality of life.
  
  
  METHODS
  We studied 100 patients with anterior wall ST-elevation AMI. All had percutaneous coronary intervention with stent in the proximal or mid left anterior descending coronary artery 2 to 12 hours after start of symptoms. Patients were randomized to intracoronary injection of mononuclear bone marrow cells (mBMCs) in left anterior descending coronary artery 6 +/- 1.3 days after AMI (n = 50) or control (n = 50). Assessment of physical capacity by maximal symptom-limited bicycle ergometer exercise tests and quality of life by the Short Form 36 health survey was performed 2 to 3 weeks and 6 months after the AMI.
  
  
  RESULTS
  There was a significantly greater improvement in exercise time in the mBMC group than in the control group (treatment effect 0.9 minute, 95% CI 0.3-1.6, P < .01), and a similar improvement in peak oxygen consumption in the groups (2.8 +/- 3.9 mL/[kg min] in the mBMC group vs 2.4 +/- 3.5 mL/[kg min] in controls, P = .62). Peak heart rate and percentage of heart rate reserve increased significantly more in the treatment group than in the control group. Treatment with mBMCs did not influence quality of life.
  
  
  CONCLUSIONS
  In this randomized open-labeled study, the mBMC group significantly improved exercise time and heart rate responses to exercise compared with the control group. There was no treatment effect on peak oxygen consumption.
authors: Department of Cardiology, Rikshospitalet-Radiumhospitalet University Hospital, Oslo, Norway.
authors: Ketil
authors: K
authors: Lunde
authors: Svein
authors: S
authors: Solheim
authors: Svend
authors: S
authors: Aakhus
authors: Harald
authors: H
authors: Arnesen
authors: Torbjørn
authors: T
authors: Moum
authors: Michael
authors: M
authors: Abdelnoor
authors: Torstein
authors: T
authors: Egeland
authors: Knut
authors: K
authors: Endresen
authors: Arnfinn
authors: A
authors: Ilebekk
authors: Arild
authors: A
authors: Mangschau
authors: Kolbjørn
authors: K
authors: Forfang
mesh_terms: D016026:Bone Marrow Transplantation / Q000379:methods; D018421:Cardiomyoplasty; D005080:Exercise Test; D017079:Exercise Tolerance / Q000502:physiology; D005260:Female; D006305:Health Status Indicators; D006339:Heart Rate; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology* / Q000601:surgery*; D010101:Oxygen Consumption; D011788:Quality of Life; D015656:Respiratory Mechanics; D014182:Transplantation, Autologous