Intracoronary administration of bone marrow-derived progenitor cells improves left ventricular function in patients at risk for adverse remodeling after acute ST-segment elevation myocardial infarction: Results of the Reinfusion of Enriched Progenitor cells And Infarct Remodeling in Acute Myocardial Infarction study (REPAIR-AMI) cardiac Magnetic Resonance Imaging substudy
Intracoronary administration of bone marrow-derived progenitor cells improves left ventricular function in patients at risk for adverse remodeling after acute ST-segment elevation myocardial infarction: Results of the Reinfusion of Enriched Progenitor cells And Infarct Remodeling in Acute Myocardial Infarction study (REPAIR-AMI) cardiac Magnetic Resonance Imaging substudy
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DOI：
10.1016/j.ahj.2008.11.011
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发表时间：
2009-03-01
影响因子：
4.8
通讯作者：
Hamm, Christian
中科院分区：
文献类型：
--
作者：
Dill, Thorsten;Schaechinger, Volker;Hamm, Christian
背景心脏磁共振成像（CMR）是评价急性心肌梗死患者左室功能、室壁运动、梗死面积以及随访期间重构的参考标准。随机多中心REPAIR-AMI试验的心脏CMR子研究方法入选204例ST段抬高型心肌梗死和直接经皮冠状动脉介入治疗的患者，随机分为两组，在磁共振成像子研究中，54名患者在入组后完成了连续CMR（基线，分别为4个月和12个月）（27名BMC，27名安慰剂）。结果两组基线时的射血分数（EF）、舒张末期容积（EDV）、收缩末期容积（ESV）均无显著性差异。在12个月时，BMC输注对EF的治疗效果为2.8个绝对百分点（P = 0.26），BMC组在12个月时EDV的进展较小（治疗效果14 mL，P = 0.12），与安慰剂组不同，ESV没有增加（绝对治疗效果13 mL，P = 0.08）。在基线EF <中位数（EF
Background Serial cardiac magnetic resonance imaging (CMR) is the reference standard for evaluating left ventricular function, wall motion, and infarct size in patients with acute myocardial infarction, as well as remodeling during follow-up. The cardiac CMR substudy of the randomized multicenter REPAIR-AMI trial (Reinfusion of Enriched Progenitor cells And Infarct Remodeling in Acute Myocardial Infarction study) aimed at gaining insight into postinfarction left ventricular remodeling processes.Methods Consecutive patients with ST-segment elevation myocardial infarction and primary percutaneous coronary intervention were enrolled (n = 204) and randomly assigned to either stem cell therapy(bone marrow-derived progenitor cells [BMC]) or placebo after bone marrow aspiration, In the magnetic resonance imaging substudy, 54 patients completed serial CMR (baseline, 4 and 12 months, respectively) after enrollment (27 BMC, 27 placebo). Image analysis was performed at a central core laboratory.Results There were no significant differences between the 2 groups with respect to global ejection fraction (EF), end-dicstolic volume (EDV), and end-systolic volume (ESV) at baseline. At 12 months, the treatment effect of BMC infusion on EF amounted to 2.8 absolute percentage points (P = .26), the progression of EDV at 12 months was less in the BMC group (treatment effect 14 mL, P = .12), and unlike Placebo, ESV did not increase (absolute treatment effect 13 mL, P = .08), respectively. In patients with a baseline EF < median (EF