Intracoronary infusion of bone marrow‐derived mononuclear cells abrogates adverse left ventricular remodelling post‐acute myocardial infarction: insights from the reinfusion of enriched progenitor cells and infarct remodelling in acute myocardial infarction (REPAIR‐AMI) trial
| Autor: | Volker, Schächinger, Birgit, Assmus, Sandra, Erbs, Albrecht, Elsässer, Werner, Haberbosch, Rainer, Hambrecht, Jiangtao, Yu, Roberto, Corti, Detlef G, Mathey, Christian W, Hamm, Torsten, Tonn, Stefanie, Dimmeler, Andreas M, Zeiher, W, Kasper |
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| Přispěvatelé: | University of Zurich, Schächinger, V |
| Rok vydání: | 2009 |
| Předmět: |
Male
medicine.medical_specialty Myocardial Infarction 610 Medicine & health Coronary Angiography Placebo Risk Assessment Severity of Illness Index Monocytes 2705 Cardiology and Cardiovascular Medicine Reperfusion therapy Double-Blind Method Reference Values Internal medicine medicine Humans Infusions Intra-Arterial cardiovascular diseases Myocardial infarction Aged Probability Proportional Hazards Models Ejection fraction Ventricular Remodeling medicine.diagnostic_test business.industry Hematopoietic Stem Cell Transplantation Stroke Volume Stroke volume Middle Aged medicine.disease Myocardial Contraction Survival Analysis humanities Treatment Outcome medicine.anatomical_structure Heart failure Multivariate Analysis Retreatment Angiography 10209 Clinic for Cardiology Cardiology Female Bone marrow Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | European Journal of Heart Failure. 11:973-979 |
| ISSN: | 1879-0844 1388-9842 |
| Popis: | Aims Depressed left ventricular ejection fraction (LVEF) despite successful reperfusion therapy is the single most powerful predictor of progressive LV enlargement after acute myocardial infarction (AMI) and independently determines adverse outcome in these patients. Methods and results We investigated the effect of intracoronary administration of bone marrow-derived mononuclear cells (BMC) within 7 days after successful reperfusion therapy for AMI, on early (within 4 months) LV remodelling processes assessed by quantitative LV angiography. Overall, 95 patients received BMC and 92 patients received placebo. Remodelling was assessed as the changes in either LVEF and end-systolic volume (ESV) or stroke volume and end-diastolic volume (EDV) at 4 months, respectively. Baseline LVEF was inversely correlated with ESV expansion at 4 months in the placebo group, but not in the BMC group. Likewise, EDV expansion was significantly correlated with baseline LVEF in the placebo (r = −0.36, P < 0.001), but not in the BMC group (r = −0.17, P = 1.0). Analysing the interaction between convalescent LV contractile function and LV volumes revealed that the increase in LVEF or stroke volume did not occur at the expense of increases in ESV or EDV, respectively, in the BMC group. Conclusion Intracoronary administration of BMC eliminates the correlation between depressed LVEF after reperfusion therapy and LV expansion during follow-up and, thereby, abrogates early LV remodelling after AMI. |
| Databáze: | OpenAIRE |
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