Abstract
BackgroundTrials have brought diverse results of bone marrow stem cell treatment in necrotic myocardium. This substudy from the Autologous Stem Cell Transplantation in Acute Myocardial Infarction trial (ASTAMI) explored global and regional myocardial function after intracoronary injection of autologous mononuclear bone marrow cells (mBMC) in acute anterior wall myocardial infarction treated with percutaneous coronary intervention.MethodsCardiovascular magnetic resonance (CMR) tagging was performed 2-3 weeks and 6 months after revascularization in 15 patients treated with intracoronary stem cell injection (mBMC group) and in 13 controls without sham injection. Global and regional left ventricular (LV) strain and LV twist were correlated to cine CMR and late gadolinium enhancement (LGE).ResultsIn the control group myocardial function as measured by strain improved for the global LV (6 months: -13.1 ± 2.4 versus 2-3 weeks: -11.9 ± 3.4%, p = 0.014) and for the infarct zone (-11.8 ± 3.0 versus -9.3 ± 4.1%, p = 0.001), and significantly more than in the mBMC group (inter-group p = 0.027 for global strain, respectively p = 0.009 for infarct zone strain). LV infarct mass decreased (35.7 ± 20.4 versus 45.7 ± 29.5 g, p = 0.024), also significantly more pronounced than the mBMC group (inter-group p = 0.034). LV twist was initially low and remained unchanged irrespective of therapy.ConclusionsLGE and strain findings quite similarly demonstrate subtle differences between the mBMC and control groups. Intracoronary injection of autologous mBMC did not strengthen regional or global myocardial function in this substudy.Trial registrationClinicalTrials.gov: NCT00199823
Highlights
Trials have brought diverse results of bone marrow stem cell treatment in necrotic myocardium
We examined whether intracoronary injection of autologous mononuclear bone marrow cells influenced regional myocardial function or left ventricular (LV) twist
There were no significant differences between the groups for ejection fraction (EF), end systolic volumes (ESV), End diastolic volumes (EDV), LV mass, infarct size, LV strain or LV twist, and there were no significant differences in myocardial mass, infarct mass, infarct percent or strain in the LV regions examined
Summary
Trials have brought diverse results of bone marrow stem cell treatment in necrotic myocardium This substudy from the Autologous Stem Cell Transplantation in Acute Myocardial Infarction trial (ASTAMI) explored global and regional myocardial function after intracoronary injection of autologous mononuclear bone marrow cells (mBMC) in acute anterior wall myocardial infarction treated with percutaneous coronary intervention. Some groups have explored regional left ventricular function as evaluated by wall motion or wall thickening assessed use of the method [12,13] In this substudy of the Autologous Stem Cell Transplantation in Acute Myocardial Infarction trial (ASTAMI) [2], we calculated LV circumferential strain and twist from short axis grid CMR tagging obtained on 28 patients first at 2-3 weeks and subsequently 6 months after the infarction. We aimed to explore the potentials for tagging analysis to detect more subtle changes in myocardial function undetectable by other examination techniques in routine use
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