title: Regional myocardial function after intracoronary bone marrow cell injection in reperfused anterior wall infarction - a cardiovascular magnetic resonance tagging study.
abstract: BACKGROUND
  Trials have brought diverse results of bone marrow stem cell treatment in necrotic myocardium. This substudy from the Autologous Stem Cell Transplantation in Acute Myocardial Infarction trial (ASTAMI) explored global and regional myocardial function after intracoronary injection of autologous mononuclear bone marrow cells (mBMC) in acute anterior wall myocardial infarction treated with percutaneous coronary intervention.
  
  
  METHODS
  Cardiovascular magnetic resonance (CMR) tagging was performed 2-3 weeks and 6 months after revascularization in 15 patients treated with intracoronary stem cell injection (mBMC group) and in 13 controls without sham injection. Global and regional left ventricular (LV) strain and LV twist were correlated to cine CMR and late gadolinium enhancement (LGE).
  
  
  RESULTS
  In the control group myocardial function as measured by strain improved for the global LV (6 months: -13.1 ± 2.4 versus 2-3 weeks: -11.9 ± 3.4%, p = 0.014) and for the infarct zone (-11.8 ± 3.0 versus -9.3 ± 4.1%, p = 0.001), and significantly more than in the mBMC group (inter-group p = 0.027 for global strain, respectively p = 0.009 for infarct zone strain). LV infarct mass decreased (35.7 ± 20.4 versus 45.7 ± 29.5 g, p = 0.024), also significantly more pronounced than the mBMC group (inter-group p = 0.034). LV twist was initially low and remained unchanged irrespective of therapy.
  
  
  CONCLUSIONS
  LGE and strain findings quite similarly demonstrate subtle differences between the mBMC and control groups. Intracoronary injection of autologous mBMC did not strengthen regional or global myocardial function in this substudy.
  
  
  BACKGROUND
  ClinicalTrials.gov: NCT00199823.
authors.affiliation: Department of Radiology, Oslo University Hospital, Rikshospitalet, Postbox 4950, Nydalen, 0424 Oslo, Norway. einar.hopp@oslo-universitetssykehus.no
authors.forename: Einar
authors.initials: E
authors.lastname: Hopp
authors.forename: Ketil
authors.initials: K
authors.lastname: Lunde
authors.forename: Svein
authors.initials: S
authors.lastname: Solheim
authors.forename: Svend
authors.initials: S
authors.lastname: Aakhus
authors.forename: Harald
authors.initials: H
authors.lastname: Arnesen
authors.forename: Kolbjørn
authors.initials: K
authors.lastname: Forfang
authors.forename: Thor
authors.initials: T
authors.lastname: Edvardsen
authors.forename: Hans-Jørgen
authors.initials: HJ
authors.lastname: Smith
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D056988:Anterior Wall Myocardial Infarction / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D016026:Bone Marrow Transplantation; D003131:Combined Modality Therapy; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007267:Injections; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D009664:Norway; D011237:Predictive Value of Tests; D020127:Recovery of Function; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA