title: Intramyocardial bone marrow-derived mononuclear cell injection for chronic myocardial ischemia: the effect on diastolic function.
abstract: BACKGROUND
  The present substudy of a recently published randomized trial aimed to investigate the effect of intramyocardial bone marrow cell injection on diastolic function in patients with chronic myocardial ischemia.
  
  
  RESULTS
  In a total of 50 patients, diastolic function was evaluated before and 3 months after bone marrow cell injection using standard echocardiography and strain analysis. In addition, MRI-derived transmitral flow measurements were obtained in a subset of 36 patients. Left ventricular ejection fraction increased from 50±5% to 54±7% in the bone marrow cell group, which was a significant improvement as compared with the placebo group (52±5% versus 51±7%, P=0.001). Filling pressure estimate E/E' ratio improved from 14±5 at baseline to 12±4 at 3 months in the bone marrow cell group, whereas no improvement was observed in the placebo group (13±4 versus 13±5). The improvement in E/E' ratio was significantly larger in the bone marrow cell group (P=0.008). Furthermore, the E/A peak flow ratio as assessed by MRI showed a significant increase in the bone marrow cell group as compared with the placebo group (+0.16±0.25 versus -0.04±0.21, P=0.01), which was mainly related to an increase in the early (E) peak flow rate in the bone marrow cell group (from 407±96 mL/s to 468±110 mL/s, P=0.009 as compared with the placebo group).
  
  
  CONCLUSIONS
  The current study demonstrates that intramyocardial bone marrow cell injection is associated with a beneficial effect on myocardial relaxation and filling pressures in patients with chronic myocardial ischemia.
authors.affiliation: Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, Leiden, The Netherlands.
authors.forename: Jan
authors.initials: J
authors.lastname: van Ramshorst
authors.forename: M Louisa
authors.initials: ML
authors.lastname: Antoni
authors.forename: Saskia L M A
authors.initials: SL
authors.lastname: Beeres
authors.forename: Stijntje D
authors.initials: SD
authors.lastname: Roes
authors.forename: Victoria
authors.initials: V
authors.lastname: Delgado
authors.forename: Sander F
authors.initials: SF
authors.lastname: Rodrigo
authors.forename: Albert
authors.initials: A
authors.lastname: de Roos
authors.forename: Eduard R
authors.initials: ER
authors.lastname: Holman
authors.forename: Willem E
authors.initials: WE
authors.lastname: Fibbe
authors.forename: Hildo J
authors.initials: HJ
authors.lastname: Lamb
authors.forename: Jaap J
authors.initials: JJ
authors.lastname: Zwaginga
authors.forename: Eric
authors.initials: E
authors.lastname: Boersma
authors.forename: Ernst E
authors.initials: EE
authors.lastname: van der Wall
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Schalij
authors.forename: Douwe E
authors.initials: DE
authors.lastname: Atsma
authors.forename: J J
authors.initials: JJ
authors.lastname: Bax
mesh_terms: D000368:Aged; D016026:Bone Marrow Transplantation; D016009:Chi-Square Distribution; D002908:Chronic Disease; D003971:Diastole; D004311:Double-Blind Method; D018618:Echocardiography, Doppler, Color; D005260:Female; D006801:Humans; D007267:Injections; D016014:Linear Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D009426:Netherlands; D020127:Recovery of Function; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left