Effect of intramyocardial bone marrow cell injection on diastolic function in patients with chronic myocardial ischemia.
OBJECTIVE
To evaluate the effect of intramyocardial bone marrow cell injection on diastolic function in patients with chronic myocardial ischemia.


METHODS
In 24 patients (19 male; 65 +/- 9 years) with refractory angina (Canadian Cardiovascular Society [CCS] class III-IV) 84.6 +/- 28.7 x 10(6) bone marrow-derived mononuclear cells were injected intramyocardially (using the NOGA system) in regions with ischemia on Tc-99m tetrofosmin single photon emission computed tomography (SPECT). Diastolic function was evaluated at baseline and at three months using magnetic resonance imaging (MRI) and tissue Doppler imaging (TDI).


RESULTS
MRI revealed an increased early (E) peak filling rate (374 +/- 121 mL/second vs. 412 +/- 102 mL/second; P = 0.04), whereas the atrial (A) peak filling rate remained unchanged (340 +/- 81 mL/second vs. 334 +/- 93 mL/second; P = not significant [NS]). The E/A peak flow ratio increased from 1.09 +/- 0.33 to 1.23 +/- 0.47 at three months (P = 0.02). TDI demonstrated a significant improvement in early diastolic velocity (E') from 4.4 +/- 1.7 cm/second to 4.8 +/- 1.6 cm/second at three months (P = 0.03), whereas the late diastolic velocity (A') remained unchanged (6.0 +/- 1.6 cm/second vs. 6.0 +/- 1.7 cm/second; P = NS). Consequently, the E'/A' ratio increased from 0.74 +/- 0.19 to 0.84 +/- 0.28 at three months (P = 0.02).


CONCLUSIONS
Intramyocardial bone marrow cell injection in patients with chronic myocardial ischemia improved MRI and TDI-derived parameters of diastolic function.
Beeres
Saskia L M A
SL
Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
Lamb
Hildo J
HJ
Roes
Stijntje D
SD
Holman
Eduard R
ER
Kaandorp
Theodorus A M
TA
Fibbe
Willem E
WE
de Roos
Albert
A
van der Wall
Ernst E
EE
Schalij
Martin J
MJ
Bax
Jeroen J
JJ
Atsma
Douwe E
DE
D000368:Aged; D016026:Bone Marrow Transplantation; D002908:Chronic Disease; D003971:Diastole; D005260:Female; D006801:Humans; D007267:Injections; D007963:Leukocytes, Mononuclear / Q000637:transplantation*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D017202:Myocardial Ischemia / Q000503:physiopathology / Q000628:therapy*; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler