Myocardial blood flow and infarct size after CD133+ cell injection in large myocardial infarction with good recanalization and poor reperfusion: results from a randomized controlled trial

Autor: E. Sacchi, Paolo Gerundini, Simone Palatresi, Massimo Castellani, Alessandro Colombo, Roberto Rech, Edoardo Rossi, Enrico Pusineri, Davide Soligo, Maurizio Viecca, Emanuela Piccaluga, Cristina Canzi, Rosaria Giordano, Paolo Rebulla, Giorgio Lambertenghi Deliliers, Virgilio Longari
Rok vydání: 2011
Předmět:
Adult
Male
medicine.medical_specialty
Time Factors
medicine.medical_treatment
Balloon
Ventricular Function
Left
law.invention
Coronary circulation
Randomized controlled trial
Antigens
CD
law
Coronary Circulation
Angioplasty
Internal medicine
Humans
Medicine
AC133 Antigen
cardiovascular diseases
Myocardial infarction
Angioplasty
Balloon
Coronary
Anterior Wall Myocardial Infarction
Bone Marrow Transplantation
Glycoproteins
Analysis of Variance
Peripheral Blood Stem Cell Transplantation
business.industry
Myocardium
Stem Cells
Stroke Volume
Recovery of Function
General Medicine
Blood flow
Stroke volume
Middle Aged
medicine.disease
Infarct size
Treatment Outcome
medicine.anatomical_structure
Italy
Echocardiography
Positron-Emission Tomography
Cardiology
Female
Stents
Peptides
Cardiology and Cardiovascular Medicine
business
Zdroj: Journal of Cardiovascular Medicine. 12:239-248
ISSN: 1558-2027
DOI: 10.2459/jcm.0b013e328343d708
Popis: Large acute ST-elevation myocardial infarction (STEMI) sometimes leaves extensive ischemic damage despite timely and successful primary angioplasty. This clinical picture of good recanalization with incomplete reperfusion represents a good model to assess the reparative potential of locally administered cell therapy. Thus, we conducted a randomized controlled trial aimed at evaluating the effect of intracoronary administration of CD133 stem cells on myocardial blood flow and function in this setting.Fifteen patients with large anterior STEMI, myocardial blush grade 0-1 and more than 50% ST-elevation recovery after optimal coronary recanalization (TIMI 3 flow) with stenting were randomly assigned to receive CD133 cells from either bone marrow (group A) or peripheral blood (group B), or to stay on drug therapy alone (group C). The cells were intracoronary injected within 10-14 days of STEMI. Infarct-related myocardial blood flow (MBF) was evaluated by NH positron emission tomography 2-5 days before cell administration and after 1 year.MBF increased in the infarct area from 0.419 (0.390-0.623) to 0.544 (0.371-0.729) ml/min per g in group A, decreased from 0.547 (0.505-0.683) to 0.295 (0.237-0.472) ml/min per g in group B and only slightly changed from 0.554 (0.413-0.662) to 0.491 (0.453-0.717) ml/min per g in group C (A vs. C: P = 0.023; B vs. C: P = 0.066). Left ventricular volume tended to increase more in groups B and C than in group A, ejection fraction and wall motion score index remained stable in the three groups.These findings support the hypothesis that intracoronary administration of bone marrow-derived, but not peripheral blood-derived CD133 cells 10-14 days after STEMI may improve long-term perfusion.
Databáze: OpenAIRE
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