Improved regional function after autologous bone marrow-derived stem cell transfer in patients with acute myocardial infarction: a randomized, double-blind strain rate imaging study.
OBJECTIVE
To investigate whether intracoronary transfer of bone marrow progenitor cells (BMPCs) early after reperfusion of an acute myocardial infarction improves regional myocardial function in a randomized double-blind, placebo-controlled strain rate imaging study.


RESULTS
Regional myocardial deformation was measured using velocity-derived strain rate imaging in 67 STEMI patients randomized 1:1 to intracoronary infusion of BMPC (n = 33) or placebo (n = 34). Myocardial segments were grouped into infarct (n = 232), border (n = 250), and remote (n = 526) based on MRI-delayed enhancement and the perfusion territory of the infarct-related vessel. Four months after revascularization and progenitor cell/placebo transfer, regional myocardial deformation (rate) improved significantly more in the infarct segments of BMPC patients (treatment effect on end-systolic strain: -3.7 +/- 1.0%, P = 0.0003; peak-systolic strain rate: -0.20 +/- 0.07 s(-1), P = 0.0035). These findings were confirmed by a significantly greater improvement of longitudinal mitral valve ring displacement in the infarct walls of BMPC patients (treatment effect: 0.93 mm, P = 0.034).


CONCLUSIONS
Intracoronary infusion of BMPC early after reperfusion of a STEMI improves recuperation of regional myocardial function at 4 months' follow-up. Quantitative assessment of regional systolic function might be more sensitive than global LV ejection fraction for the evaluation of BMPC therapy after STEMI.
Herbots
Lieven
L
Department of Cardiology, Gasthuisberg University Hospital, University of Leuven, 49 Herestraat, B-3000 Leuven, Belgium. lieven.herbots@uz.kuleuven.ac.be
D'hooge
Jan
J
Eroglu
Elif
E
Thijs
Daisy
D
Ganame
Javier
J
Claus
Piet
P
Dubois
Christophe
C
Theunissen
Koen
K
Bogaert
Jan
J
Dens
Joseph
J
Kalantzi
Maria
M
Dymarkowski
Steven
S
Bijnens
Bart
B
Belmans
Ann
A
Boogaerts
Marc
M
Sutherland
George
G
Van de Werf
Frans
F
Rademakers
Frank
F
Janssens
Stefan
S
D000368:Aged; D016026:Bone Marrow Transplantation; D003326:Coronary Circulation / Q000502:physiology; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D013318:Stroke Volume / Q000502:physiology; D016896:Treatment Outcome; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery