Left ventricular systolic and diastolic function improve after acute myocardial infarction treated with acute percutaneous coronary intervention, but are not influenced by intracoronary injection of autologous mononuclear bone marrow cells: a 3 year serial echocardiographic sub-study of the randomized-controlled ASTAMI study.
OBJECTIVE
To clarify long-term changes in global, regional, and diastolic left ventricular (LV) function after intracoronary injection of autologous mononuclear bone marrow cells (mBMCs) in acute myocardial infarction (AMI).


RESULTS
In the Autologous Stem cell Transplantation in Acute Myocardial Infarction (ASTAMI) study, 100 patients with anterior ST-elevation myocardial infarction and percutaneous coronary intervention on the left anterior descending artery (LAD) were randomized to receive intracoronary injection of mBMCs or not. Transthoracic echocardiography was performed at baseline, 3, 6, 12 months, and 3 years. Regional LV function was assessed by two-dimensional speckle-tracking echocardiography. From baseline to 3 years, LV ejection fraction changed from 45.7 to 47.5% in the mBMC group, and from 46.9 to 46.8% in the control group (P = 0.87 for difference in change over time between groups). Longitudinal strain in the LAD territory improved from -9.7 to -12.2% in the mBMC group and from -9.9 to -12.8% in the control group (P = 0.45). E/e' decreased from 14.7 to 12.9 in the mBMC group and from 14.8 to 11.9 in the control group (P = 0.31). There were no significant differences between groups in change of LV volumes, global systolic function, regional function, or diastolic function during 3 years follow-up.


CONCLUSIONS
No differences between groups indicating beneficial effect of intracoronary mBMC injection could be identified. Both groups in ASTAMI experienced improvement of global, regional, and diastolic LV function after 3-6 months, with effects sustained at 3 years.
Beitnes
Jan Otto
JO
Department of Cardiology, Oslo University Hospital, Rikshospitalet, 0027 Oslo, Norway. jan.otto.beitnes@rikshospitalet.no
Gjesdal
Ola
O
Lunde
Ketil
K
Solheim
Svein
S
Edvardsen
Thor
T
Arnesen
Harald
H
Forfang
Kolbjørn
K
Aakhus
Svend
S
D015906:Angioplasty, Balloon, Coronary; D016026:Bone Marrow Transplantation / Q000379:methods; D064987:Cell- and Tissue-Based Therapy; D003971:Diastole; D004452:Echocardiography; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D007963:Leukocytes, Mononuclear / Q000637:transplantation*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000628:therapy*; D013223:Statistics as Topic; D013599:Systole; D013997:Time Factors; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000628:therapy*; D016277:Ventricular Function, Left