title: Predictors of ventricular remodelling in patients with reperfused acute myocardial infarction and left ventricular dysfunction candidates for bone marrow cell therapy: insights from the BONAMI trial.
abstract: OBJECTIVE
  Few data are available regarding the relation of left ventricular (LV) mechanical dyssynchrony to remodelling after acute myocardial infarction (MI) and stem cell therapy. We evaluated the 1-year time course of both LV mechanical dyssynchrony and remodelling in patients enrolled in the BONAMI trial, a randomized, multicenter controlled trial assessing cell therapy in patients with reperfused MI.
  
  
  METHODS
  Patients with acute MI and ejection fraction (EF) ≤ 45 % were randomized to cell therapy or to control and underwent thallium single-photon emission computed tomography (SPECT), radionuclide angiography, and echocardiography at baseline, 3 months, and 1 year. Eighty-three patients with a comprehensive 1-year follow-up were included. LV dyssynchrony was assessed by the standard deviation (SD) of the LV phase histogram using radionuclide angiography. Remodelling was defined as a 20 % increase in LV end-systolic volume index (LVESVI) at 1 year.
  
  
  RESULTS
  At baseline, LVEF, wall motion score index, and perfusion defect size were significantly impaired in the 43 patients (52 %) with LV remodelling (all p < 0.001), without significant increase in LV mechanical dyssynchrony. During follow-up, there was a progressive increase in LV SD (p = 0.01). Baseline independent predictors of LV remodelling were perfusion SPECT defect size (p = 0.001), LVEF (p = 0.01) and a history of hypertension (p = 0.043). Bone marrow cell therapy did not affect the time-course of LV remodelling and dyssynchrony.
  
  
  CONCLUSIONS
  LV remodelling 1 year after reperfused MI is associated with progressive LV dyssynchrony and is related to baseline infarct size and ejection fraction, without impact of cell therapy on this process.
authors.affiliation: Nuclear Medicine, CHU de Caen, Caen, F-14000, France. manrique@cyceron.fr.|EA 4650, Université de Caen Normandie, Caen, F-14000, France. manrique@cyceron.fr.|CHU de Caen et GIP Cyceron, Campus Jules Horowitz, BP 5229, 14074, Caen cedex 6, France. manrique@cyceron.fr.
authors.forename: Alain
authors.initials: A
authors.lastname: Manrique
authors.affiliation: INSERM, UMR1087, l'institut du thorax, Nantes, F-44000, France.|CNRS, UMR 6291, Nantes, F-44000, France.|Université de Nantes, Nantes, F-44000, France.|CHU de Nantes, Nantes, F-44000, France.
authors.forename: Patricia
authors.initials: P
authors.lastname: Lemarchand
authors.affiliation: INSERM, UMR1087, l'institut du thorax, Nantes, F-44000, France.|CNRS, UMR 6291, Nantes, F-44000, France.|Université de Nantes, Nantes, F-44000, France.|CHU de Nantes, Nantes, F-44000, France.
authors.forename: Béatrice
authors.initials: B
authors.lastname: Delasalle
authors.affiliation: Cardiac Imaging Center, CIC Biothérapies, CHU de Toulouse, Institut CARDIOMET-Toulouse, Toulouse, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Lairez
authors.affiliation: Institut de Génomique Fonctionnelle, INSERM U661, CNRS UMR 5203, Université Montpellier, Montpellier, France.|Clinique du Millénaire, Montpellier, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Sportouch-Duckan
authors.affiliation: INSERM, UMR1087, l'institut du thorax, Nantes, F-44000, France.|CNRS, UMR 6291, Nantes, F-44000, France.|Université de Nantes, Nantes, F-44000, France.|CHU de Nantes, Nantes, F-44000, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Lamirault
authors.affiliation: INSERM, Centre d'Investigation Clinique 1430 et U955 équipe 3, Hôpital Henri Mondor, Créteil, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Le Corvoisier
authors.affiliation: Pole Thorax et Vaisseaux, CHU de Grenoble, Grenoble, France.
authors.forename: Yannick
authors.initials: Y
authors.lastname: Neuder
authors.affiliation: Service d'Explorations Fonctionnelles Cardiovasculaires, Hôpital Cardiologique, CHRU Lille, Lille, France.
authors.forename: Marjorie
authors.initials: M
authors.lastname: Richardson
authors.affiliation: Service de Cardiologie, CHU de Caen, Caen, F-14000, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Lebon
authors.affiliation: Cardiac Imaging Center, CIC Biothérapies, CHU de Toulouse, Institut CARDIOMET-Toulouse, Toulouse, France.
authors.forename: Jérome
authors.initials: J
authors.lastname: Roncalli
authors.affiliation: Institut de Génomique Fonctionnelle, INSERM U661, CNRS UMR 5203, Université Montpellier, Montpellier, France.|Clinique du Millénaire, Montpellier, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Piot
authors.affiliation: INSERM, UMR1087, l'institut du thorax, Nantes, F-44000, France.|CNRS, UMR 6291, Nantes, F-44000, France.|Université de Nantes, Nantes, F-44000, France.|CHU de Nantes, Nantes, F-44000, France.
authors.forename: Jean-Noel
authors.initials: JN
authors.lastname: Trochu
authors.affiliation: AP-HP, unité de cardiologie interventionnelle et fédération de cardiologie, Hôpital Henri Mondor, Créteil, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Teiger
authors.affiliation: Service de médecine nucléaire, Hôpital Salengro CHRU de Lille, Lille, France.|UFR de Médecine, Université de Lille 2, Lille, France.
authors.forename: Claude
authors.initials: C
authors.lastname: Hossein-Foucher
authors.affiliation: INSERM, UMR1087, l'institut du thorax, Nantes, F-44000, France.|CNRS, UMR 6291, Nantes, F-44000, France.|Université de Nantes, Nantes, F-44000, France.|CHU de Nantes, Nantes, F-44000, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Le Tourneau
mesh_terms: D000328:Adult; D000368:Aged; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000628:therapy*; D055414:Myocardial Perfusion Imaging; D019275:Radiopharmaceuticals; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon; D018487:Ventricular Dysfunction, Left; D020257:Ventricular Remodeling
chemical_list: D019275:Radiopharmaceuticals; D013794:Thallium Radioisotopes
keywords: Cell therapy; Dyssynchrony; Echocardiography; Myocardial infarction; Single photon emission computer tomography; Ventricular remodelling