title: Recovery of microcirculation after intracoronary infusion of bone marrow mononuclear cells or peripheral blood mononuclear cells in patients treated by primary percutaneous coronary intervention the Doppler substudy of the Hebe trial.
abstract: OBJECTIVE
  In the present substudy of the Hebe trial, we investigated the effect of intracoronary bone marrow mononuclear cell (BMMC) and peripheral blood mononuclear cell (PBMC) therapy on the recovery of microcirculation in patients with reperfused ST-segment elevation myocardial infarction (STEMI).
  
  
  BACKGROUND
  Several studies have suggested that cell therapy enhances neovascularization after STEMI.
  
  
  METHODS
  Paired Doppler flow measurements were available for 23 patients in the BMMC group, 18 in the PBMC group, and 19 in the control group. Coronary flow was assessed at 3 to 8 days after primary percutaneous coronary intervention (PCI) and repeated at 4-month follow-up, with intracoronary Doppler flow measurements.
  
  
  RESULTS
  At baseline, the coronary flow velocity reserve was reduced in the infarct-related artery and improved over 4 months in all 3 groups. The increase of coronary flow velocity reserve did not significantly differ between the 2 treatment groups and the control group (BMMC group: 2.0 ± 0.5 to 3.1 ± 0.7; PBMC group: 2.2 ± 0.6 to 3.2 ± 0.8; control group: 2.0 ± 0.5 to 3.4 ± 0.9). Additionally, the decrease in hyperemic microvascular resistance index from baseline to 4-month follow-up was not statistically different between the 2 treatment groups and the control group.
  
  
  CONCLUSIONS
  In STEMI patients treated with primary PCI in the Hebe trial, adjuvant therapy with BMMCs or PBMCs does not improve the recovery of microcirculation. Therefore, our data do not support the hypothesis of enhanced neovascularization after this mode of cell therapy. (Multicenter, randomised trial of intracoronary infusion of autologous mononuclear bone marrow cells or peripheral mononuclear blood cells after primary percutaneous coronary intervention [PCI]; ISRCTN95796863).
authors.affiliation: Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: Anja M
authors.initials: AM
authors.lastname: van der Laan
authors.forename: Alexander
authors.initials: A
authors.lastname: Hirsch
authors.forename: Joost D E
authors.initials: JD
authors.lastname: Haeck
authors.forename: Robin
authors.initials: R
authors.lastname: Nijveldt
authors.forename: Ronak
authors.initials: R
authors.lastname: Delewi
authors.forename: Bart J
authors.initials: BJ
authors.lastname: Biemond
authors.forename: Jan G P
authors.initials: JG
authors.lastname: Tijssen
authors.forename: Koen M J
authors.initials: KM
authors.lastname: Marques
authors.forename: Felix
authors.initials: F
authors.lastname: Zijlstra
authors.forename: Albert C
authors.initials: AC
authors.lastname: van Rossum
authors.forename: Jan J
authors.initials: JJ
authors.lastname: Piek
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D001783:Blood Flow Velocity; D016026:Bone Marrow Transplantation; D003131:Combined Modality Therapy; D003326:Coronary Circulation; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D007963:Leukocytes, Mononuclear / Q000637:transplantation*; D016014:Linear Models; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D018919:Neovascularization, Physiologic; D009426:Netherlands; D020127:Recovery of Function; D013997:Time Factors; D016896:Treatment Outcome