Repeated Intramyocardial Bone Marrow Cell Injection in Previously Responding Patients With Refractory Angina Again Improves Myocardial Perfusion, Anginal Complaints, and Quality of Life
| Autor: | Imke Mann, Ron Wolterbeek, Martin J. Schalij, Albert de Roos, Saskia L.M.A. Beeres, Willem E. Fibbe, Douwe E. Atsma, Jan van Ramshorst, Petra Dibbets-Schneider, Sander F. Rodrigo, Jeroen J. Bax, Jaap Jan Zwaginga |
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| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Cardiac Catheterization bone marrow medicine.medical_treatment Ischemia Myocardial Ischemia Bone Marrow Cells ischemia tomography Transplantation Autologous Ventricular Function Left Angina Myocardial perfusion imaging angina pectoris Internal medicine medicine Humans emission-computed cell transplantation Cardiac catheterization Aged Bone Marrow Transplantation Exercise Tolerance medicine.diagnostic_test business.industry Myocardial Perfusion Imaging Magnetic resonance imaging Canadian Cardiovascular Society Middle Aged medicine.disease Magnetic Resonance Imaging medicine.anatomical_structure Treatment Outcome Cardiology Quality of Life Female Bone marrow single-photon Cardiology and Cardiovascular Medicine business Perfusion |
| Zdroj: | Circulation: Cardiovascular Interventions, 8(8) |
| Popis: | Background— Intramyocardial bone marrow cell injection is associated with improvements in myocardial perfusion and anginal symptoms in patients with refractory angina pectoris. This study evaluates the effect of repeated intramyocardial bone marrow cell injection in patients with residual or recurrent myocardial ischemia. Methods and Results— Twenty-three patients (17 men; 69±9 years) who had improved myocardial perfusion after the first injection but had residual or recurrent angina and ischemia on single-photon emission computed tomographic myocardial perfusion imaging were included. Patients again received intramyocardial injection of 100×10 6 autologous bone marrow mononuclear cells, 4.6±2.5 years after their first injection. No periprocedural complications occurred. Myocardial perfusion assessed using single-photon emission computed tomographic myocardial perfusion imaging improved from a summed stress score of 27.3±5.8 at baseline to 24.5±4.4 at 3 months ( P =0.002) and 25.4±4.9 at 12 months of follow-up ( P =0.002). Perfusion improvement after 3 months was comparable with the effect of the first injection ( P =0.379). Anginal complaints improved ≤12 months after cell injection in Canadian Cardiovascular Society score (mean change at 3, 6, and 12 months: 0.6±0.9%, 0.5±0.9%, and 0.6±0.9%, respectively; P slope =0.007, first versus repeated; P =0.188) and in quality of life score as measured by Seattle Angina Questionnaire (mean change at 3, 6, and 12 months: 7±14%, 8±14%, and 7±15%, respectively; P slope =0.020, first versus repeated; P =0.126). Conclusions— Repeated bone marrow cell injection in previously responding patients with refractory angina is associated with improvements in myocardial perfusion, anginal complaints, and quality of life score ≤12 months of follow-up. Clinical Trial Registration— URL: http://www.trialregister.nl . Unique identifier: NTR2664. |
| Databáze: | OpenAIRE |
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