Key result
Intracoronary infusion of bone marrow progenitor cells early after STEMI reperfusion significantly improved regional end-systolic strain at 4 months compared to placebo (MD -3.7%; P=0.0003).
Why the study?
Does intracoronary infusion of bone marrow progenitor cells improve regional myocardial function in STEMI patients early after reperfusion?
RCT (n=67)
Double-blind
1:1
Does intracoronary infusion of bone marrow progenitor cells improve regional myocardial function in STEMI patients early after reperfusion?
Mean Difference: -3.7
p-value: p=0.0003
Intracoronary infusion of bone marrow progenitor cells early after STEMI reperfusion significantly improves regional myocardial function at 4 months.
Supports early intracoronary bone marrow cell use to enhance regional LV function post-STEMI; confirms efficacy in RCT with strain endpoint.
AIMS: To investigate whether intracoronary transfer of bone marrow progenitor cells (BMPCs) early after reperfusion of an acute myocardial infarction improves regional myocardial function in a randomized double-blind, placebo-controlled strain rate imaging study. METHODS AND RESULTS: Regional myocardial deformation was measured using velocity-derived strain rate imaging in 67 STEMI patients randomized 1:1 to intracoronary infusion of BMPC (n = 33) or placebo (n = 34). Myocardial segments were grouped into infarct (n = 232), border (n = 250), and remote (n = 526) based on MRI-delayed enhancement and the perfusion territory of the infarct-related vessel. Four months after revascularization and progenitor cell/placebo transfer, regional myocardial deformation (rate) improved significantly more in the infarct segments of BMPC patients (treatment effect on end-systolic strain: -3.7 +/- 1.0%, P = 0.0003; peak-systolic strain rate: -0.20 +/- 0.07 s(-1), P = 0.0035). These findings were confirmed by a significantly greater improvement of longitudinal mitral valve ring displacement in the infarct walls of BMPC patients (treatment effect: 0.93 mm, P = 0.034). CONCLUSION: Intracoronary infusion of BMPC early after reperfusion of a STEMI improves recuperation of regional myocardial function at 4 months' follow-up. Quantitative assessment of regional systolic function might be more sensitive than global LV ejection fraction for the evaluation of BMPC therapy after STEMI.
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Herbots et al. (2008) conducted an RCT in Acute myocardial infarction (STEMI) (n=67). Intracoronary infusion of bone marrow progenitor cells (BMPCs) vs. Placebo was evaluated on Regional myocardial deformation (end-systolic strain) in infarct segments (MD -3.7%, p=0.0003). Intracoronary infusion of bone marrow progenitor cells early after STEMI reperfusion significantly improved regional end-systolic strain at 4 months compared to placebo (MD -3.7%; P=0.0003).
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