title: Effects of Bone Marrow Mononuclear Cells Delivered through a Graft Vessel for Patients with Previous Myocardial Infarction and Chronic Heart Failure: An Echocardiographic Study of Left Ventricular Function.
abstract: OBJECTIVE
  The graft of stem cells to treat ischemic cardiomyopathy is popular in many clinical trials. The aim of this study was to evaluate the effectiveness of isolated coronary artery bypass graft combined with bone marrow mononuclear cells (BMMNC) delivered through graft vessels to improve left ventricular function of patients with previous myocardial infarction and chronic heart failure using echocardiography.
  
  
  METHODS
  Forty-two patients with previous myocardial infarction and chronic heart failure were randomly allocated to one of the two groups: CABG only (18 in CABG group), or CABG with BMMNC transplantation (24 in CABG + BMMNC group). Echocardiographic parameters of systolic function were measured on B-mode imaging, tissue Doppler imaging (TDI), two-dimensional (2D) strain imaging, and 8 parameters were measured totally. Echocardiographic parameters of diastolic function were measured on pulsed-wave Doppler imaging, TDI, and 2D strain rate imaging; 17 parameters were measured totally.
  
  
  RESULTS
  Postoperative left ventricular ejection fraction (LVEF) versus preoperative LVEF were 49.083 ± 1.914% versus 36.042 ± 1.185% (P < 0.05) in CABG + BMMMNC group and 41.389 ± 2.210% versus 34.667 ± 1.369% (P < 0.05) in CABG group, global longitudinal strain were -12.542 ± 0.512% versus -7.083 ± 0.583% (P < 0.05) in CABG + BMMMNC group and -9.278 ± 0.591% versus -7.000 ± 0.673% (P < 0.05) in CABG group, mLsr1 were -0.108 ± 0.018/sec versus -0.039 ± 0.017/sec (P < 0.05) in CABG+BMMMNC group and -0.048 ± 0.021/sec versus 0.004 ± 0.020/sec (P < 0.05) in CABG group, mLsr2 were -0.055 ± 0.013/sec versus -0.009 ± 0.015/sec (P < 0.05) in CABG + BMMMNC group and 0.004 ± 0.015/sec versus 0.024 ± 0.017/sec (P < 0.05) in CABG group, and Aa1 were 7.303 ± 0.479 cm/sec versus 5.131 ± 0.381 cm/sec (P < 0.05) in CABG + BMMMNC group and 7.908 ± 0.553 cm/sec versus 6.764 ± 0.440 cm/sec (P < 0.05) in CABG group. Parameters above were significantly improved postoperatively in both groups. The degree of the improvement was significantly different between the two groups with the CABG + BMMNC group improved more versus the group of CABG only (P < 0.05).
  
  
  CONCLUSIONS
  The improvement of left ventricular function in CABG + BMMNC group is better than CABG group. 2D strain and strain rate imaging is a more sensitive tool to evaluate left ventricular function.
authors.affiliation: Department of Echocardiography, Fuwai Hospital & Cardiovascular Institute, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Tsinghua University, Peking Union Medical College, Beijing, China.
authors.forename: Zhi
authors.initials: Z
authors.lastname: Qi
authors.affiliation: Department of Echocardiography, Fuwai Hospital & Cardiovascular Institute, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Tsinghua University, Peking Union Medical College, Beijing, China.
authors.forename: Fujian
authors.initials: F
authors.lastname: Duan
authors.affiliation: Department of Cardiovascular Surgery, Fuwai Hospital & Cardiovascular Institute, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Tsinghua University, Peking Union Medical College, Beijing, China.
authors.forename: Sheng
authors.initials: S
authors.lastname: Liu
authors.affiliation: Department of Echocardiography, Fuwai Hospital & Cardiovascular Institute, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Tsinghua University, Peking Union Medical College, Beijing, China.
authors.forename: Xiuzhang
authors.initials: X
authors.lastname: Lv
authors.affiliation: Department of Echocardiography, Fuwai Hospital & Cardiovascular Institute, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Tsinghua University, Peking Union Medical College, Beijing, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Echocardiography, Fuwai Hospital & Cardiovascular Institute, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Tsinghua University, Peking Union Medical College, Beijing, China.
authors.forename: Yiming
authors.initials: Y
authors.lastname: Gao
authors.affiliation: Department of Echocardiography, Fuwai Hospital & Cardiovascular Institute, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Tsinghua University, Peking Union Medical College, Beijing, China.
authors.forename: Jianpeng
authors.initials: J
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D058948:Cell Tracking / Q000379:methods; D003131:Combined Modality Therapy; D001026:Coronary Artery Bypass; D004452:Echocardiography / Q000379:methods*; D054459:Elasticity Imaging Techniques / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D045164:Mesenchymal Stem Cell Transplantation / Q000379:methods*; D059630:Mesenchymal Stem Cells / Q000000981:diagnostic imaging*; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology / Q000517:prevention & control*; D055815:Young Adult
keywords: 2D strain and strain rate imaging; chronic heart failure; echocardiography; left ventricular function