Improved exercise capacity and ischemia 6 and 12 months after transendocardial injection of autologous bone marrow mononuclear cells for ischemic cardiomyopathy
Improved exercise capacity and ischemia 6 and 12 months after transendocardial injection of autologous bone marrow mononuclear cells for ischemic cardiomyopathy
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DOI：
10.1161/01.cir.0000138398.77550.62
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发表时间：
2004-09-14
期刊：
影响因子：
37.8
通讯作者：
Willerson, JT
中科院分区：
文献类型：
--
作者：
Perin, EC;Dohmann, HFR;Willerson, JT
背景：我们最近报道了自体骨髓单个核细胞（ABMMNC）注射到终末期缺血性心肌病患者缺血心肌区域的安全性和可行性。本研究在6个月和12个月的随访中评估了这种疗法的安全性和有效性。方法和结果：20例患者进行了6个月和12个月的随访（11例治疗组，9例对照组），纳入了这项前瞻性、非随机、开放标签的研究。在基线和随访时进行完整的临床和实验室评估、运动应激（斜坡跑步机）、二维多普勒超声心动图、单光子发射计算机断层扫描（SPECT）灌注扫描和24小时Holler监测。经心内膜送出abmmnc，借助机电定位识别存活心肌。每例患者接受ABMMNC注射15次，每次0.2 mL。在6个月和12个月时，通过SPECT灌注扫描测量的总可逆缺陷，治疗组与对照组相比显着减少。12个月时，运动能力显著提高。治疗组有所改善。这种改善与单核细胞、b细胞、造血祖细胞和早期造血祖细胞表型密切相关。结论本研究6个月和12个月的随访数据表明，经心内膜注射abmmnc对终末期缺血性心脏病患者可产生持久的治疗效果，并可改善心肌灌注和运动能力。
Background-We recently reported the safety and feasibility of autologous bone marrow mononuclear cell (ABMMNC) injection into areas of ischemic myocardium in patients with end-stage ischemic cardiomyopathy. The present study evaluated the safety and efficacy of this therapy at 6- and 12-month follow-up.Methods and Results-Twenty patients with 6- and 12-month follow-up (11 treated subjects; 9 controls) were enrolled in this prospective, nottrandomized, open-label study. Complete clinical and laboratory evaluations as well as exercise stress (ramp treadmill), 2-dimensional Doppler echocardiography, single-photon emission computed tomography (SPECT) perfusion scanning, and 24-hour Holler monitoring were performed at baseline and follow-up. Transendocardial delivery of ABMMNCs was performed with the aid of electromechanical mapping to identify viable myocardium. Each patient received 15 ABMMNC injections of 0.2 mL each. At 6 and 12 months, total reversible defect, as measured by SPECT perfusion scanning, was significantly reduced in the treatment group as compared with the control group. At 12 months, exercise capacity was significantly. improved in the treatment group. This improvement correlated well with monocyte, B-cell, hematopoietic progenitor cell, and early hemapoietic progenitor cell phenotypes.Conclusions-The 6- and 12-month follow-up data in this study suggest that transendocardial injection of ABMMNCs in patients with end-stage ischemic heart disease may produce a durable therapeutic effect and improve myocardial perfusion and exercise capacity.