Intramyocardial bone marrowderived mononuclear cell injection for chronic myocardial ischemia: The effect on diastolic function
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. Methods and 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.
|Keywords||Bone marrow mononuclear cells, Diastolic function, Echocardiography, MRI, Strain|
|Persistent URL||dx.doi.org/10.1161/CIRCIMAGING.110.957548, hdl.handle.net/1765/34684|
Ramshorst, J.V., Antoni, M.L., Beeres, S.L.M.A., Roes, S., Delgado, V., Rodrigo, S.F., … Bax, J.J.. (2011). Intramyocardial bone marrowderived mononuclear cell injection for chronic myocardial ischemia: The effect on diastolic function. Circulation. Cardiovascular Imaging, 4(2), 122–129. doi:10.1161/CIRCIMAGING.110.957548