Effects of bone marrow mononuclear cells delivered through a graft vessel in patients with previous myocardial infarction and chronic heart failure: An echocardiographic study of left ventricular dyssynchrony

2018 ◽  
Vol 46 (8) ◽  
pp. 512-518 ◽  
Author(s):  
Zhi Qi ◽  
Sheng Liu ◽  
Fujian Duan
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Bone Marrow ◽  
Mononuclear Cells ◽  
Left Ventricular ◽  
Left Ventricular Dyssynchrony ◽  
Bone Marrow Mononuclear Cells ◽  
Previous Myocardial Infarction ◽  
Ventricular Dyssynchrony ◽  
Echocardiographic Study

Abstract 20556: Safety and Efficacy of Intracoronary Hypoxia-PrecondItioned Bone Marrow Mononuclear Cells Administration for Acute Myocardial Infarction Patients

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Xin Yang Hu ◽  
Xin Huang ◽  
Qian Yang ◽  
Lihan Wang ◽  
Jianzhong Sun ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Bone Marrow ◽  
Primary Endpoint ◽  
Perfusion Defect ◽  
Mononuclear Cells ◽  
Left Ventricular ◽  
Bone Marrow Mononuclear Cells ◽  
Safety And Efficacy ◽  
Intracoronary Infusion

IMPORTANCE: Cell therapy has been a potential approach for ST-segment elevation acute myocardial infarction (STEMI). To improve the therapeutic oucome, the safety and efficacy of hypoxia-preconditioned (H-) bone marrow mononuclear cells (BMCs) in AMI patients need further evaluation. OBJECTIVE: To investigate the safety and efficacy of H-BMCs therapy in AMI patients. DESIGN: A phase 1, randomized and blinded study (February, 2011~ March, 2012) with one-year of follow-up. SETTING: A single center for hospitalized care. PARTICIPANTS: 22 Patients with an acute ST elevation myocardial infarction were recruited and randomized to two groups: normoxia BMCs (N-, n=11) and H-BMCs (n=11). INTERVENTIONS: Intracoronary infusion of H-BMCs or N-BMCs within 5-7 days after treatment with percutaneous transluminal coronary intervention (PCI). Patients were similarly treated by a stop-flow technique through an over-the-wire balloon catheter. MAIN OUTCOMES AND MEASURES: Primary endpoint was Treatment-emergent 30-day serious adverse event rate defined as a composite of death, MI, sustained ventricular tachycardia, stroke, hospitalization for worsening heart failure and revascularization. Secondary endpoints were change of myocardium perfusion, global left ventricular ejection fraction and left ventricular volumes. RESULTS: The primary endpoint events was none for N-BMCs and 9.1% (95% CI, 0.2%-41.3%) for H-BMCs. There was significant increase in the change of LVEF of H-BMCs group at 6 month. The change of end diastolic volume (EDV) and end systolic volume (ESV) in H-BMCs at 12 month were significantly decreased. Ratio of myocardium perfusion defect by Single-Photon Emission Computed Tomography (SPECT) was significantly reduced in H-BMCs group at 6 months, and score of myocardium perfusion defect by SPECT was significantly reduced than that of baseline in H-BMCs group at 6 and 12 months, unlike N- group. CONCLUSIONS AND RELEVANCE: Intracoronary infusion with H-BMCs appeared to be safe and effective for patients with AMI. Although the sample size precludes a definitive statement about safety and efficacy, these results provide the basis for larger studies to provide definitive evidence about safety and to assess efficacy of this new therapeutic approach.

scholarly journals Strengthening effects of bone marrow mononuclear cells with intensive atorvastatin in acute myocardial infarction

Open Heart ◽  
2020 ◽  
Vol 7 (1) ◽  
pp. e001139
Author(s):  
Yue-Jin Yang ◽  
Hai-Yan Qian ◽  
Lei Song ◽  
Yong-Jian Geng ◽  
Run-lin Gao ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Bone Marrow ◽  
Mononuclear Cells ◽  
Autologous Bone Marrow ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Bone Marrow Mononuclear Cells ◽  
Ventricular Ejection Fraction ◽  
Positron Emission ◽  
Registration Number

ObjectiveTo test whether intensive atorvastatin (ATV) increases the efficacy of transplantation with autologous bone marrow mononuclear cells (MNCs) in patients suffering from anterior ST-elevated myocardial infarction (STEMI).MethodsThis clinical trial was under a 2×2 factorial design, enrolling 100 STEMI patients, randomly into four groups of regular (RA) or intensive ATV (IA) with MNCs or placebo. The primary endpoint was the change of left ventricular ejection fraction (LVEF) at 1-year follow-up from baseline, primarily assessed by MRI. The secondary endpoints included other parameters of cardiac function, remodelling and regeneration determined by MRI, echocardiography, positron emission tomography (PET) and biomarkers.ResultsAll the STEMI patients with transplantation of MNCs showed significantly increased LVEF change values than those with placebo (p=0.01) with only in the IA+MNCs patients group demonstrating significantly elevation of LVEF than in the IA+placebo group (+12.6% (95%CI 10.4 to 19.3) vs +5.0% (95%CI 4.0 to 10.0), p=0.001), pointing to a better synergy between ATV and MNCs (p=0.019). PET analysis revealed significantly increased viable areas of myocardium (p=0.015), while the scar sizes (p=0.026) and blood aminoterminal pro-B-type natriuretic peptide (p<0.034) reduced. All these above benefits of MNCs were also attributed to IA+MNCs instead of RA+MNCs group of patients with STEMI.ConclusionsIntensive ATV treatment augments the therapeutic efficacy of MNCs in patients with anterior STEMI at the convalescent stage. The treatment with the protocol of intensive ATV and MNC combination offers a clinically essential approach for myocardial infarction.Trial registration numberNCT00979758.

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