Transcoronary infusion of bone marrow derived multipotent stem cells to preserve left ventricular geometry and function after myocardial infarction.
Transcoronary infusion of bone marrow derived multipotent stem cells to preserve left ventricular geometry and function after myocardial infarction.
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DOI：
10.1002/clc.20545
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发表时间：
2010-07-01
影响因子：
2.7
通讯作者：
Hongeng, Suradej
中科院分区：
文献类型：
--
作者：
Boonbaichaiyapruck, Sarana;Pienvichit, Pavit;Hongeng, Suradej
背景：心肌梗死（MI）后的心肌损伤在晚期再灌注后被认为是不可逆的。在梗死灶内注入多能干细胞（MSC）可使心肌和毛细血管网络再生。假设：急性心肌梗死后经冠状动脉向梗死相关动脉灌注骨髓源性多能干细胞是可行、安全且能改善左心室功能的。方法：我们对st段抬高心肌梗死患者进行了一项初步研究，这些患者接受了晚期再灌注治疗，并保持了血流动力学稳定。骨髓来源的间充质干细胞在短暂的低压（2atm）球囊充气过程中注入未闭梗死相关冠状动脉。在基线和8周后分别行3-T钆基MRI评估梗死面积和左室功能。结果：我们招募了10例患者，年龄63.8 +/- 2.8岁，5.2 +/- 4.12 x 10(6) MSC在梗死后24.8 +/- 16天通过冠状动脉输注。所有患者手术均成功，无院内事件发生。MRI示梗死面积在8周内减少5.84% （P = 0.018）。平均基线左室射血分数（LVEF）为44.1% +/- 9%，8周时为46.3% +/- 9% （P = 0.34）。左室舒张末期容积有减小趋势（65.02 +/- 18.2 ml vs 63.04 +/- 21.89 ml），但左室舒张末期容积无变化。结论：心肌梗死后冠脉循环灌注MSC是可行且安全的。由于左室几何形状的保留，梗死面积减小。
BACKGROUND: Myocardial damage after myocardial infarction (MI) was deemed irreversible after late reperfusion. Administration of multipotent stem cell (MSC) into such infarct may regenerate the myocardium and capillary network.HYPOTHESIS: Transcoronary infusion of bone marrow derived multipotent stem cells into infarcted related artery after acute myocardial infarction is feasible, safe and improve left ventricular function.METHODS: We conducted a pilot study in patients who survived ST-elevation MI with late reperfusion therapy and remained hemodynamically stable. Bone marrow derived MSC was infused into a patent infarct-related coronary artery during brief low pressure (2 atm) balloon inflation. A 3-T gadolinium-based MRI was performed at baseline and 8 weeks later to evaluate infarct area and LV function.RESULTS: We enrolled 10 patients, age 63.8 +/- 2.8 years 5.2 +/- 4.12 x 10(6) MSC were infused via coronary artery 24.8 +/- 16 days after infarction. The procedures were successful in all patients without any in-hospital event. Infarct size by MRI decreased by 5.84% (P = .018) over 8 weeks. Mean baseline left ventricular ejection fraction (LVEF) was 44.1% +/- 9% and was 46.3% +/- 9% at 8 weeks (P = .34). A trend of smaller LV end-systolic volume with 65.02 +/- 18.2 ml vs 63.04 +/- 21.89 ml (P = .09) with no change of LV end-diastolic volume observed.CONCLUSION: MSC infusion into coronary circulation was feasible and safe after myocardial infarction. Infarct size was reduced with preservation of LV geometry.