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Published on: May 26, 2021
Systolic function of patients with myocardial infarction undergoing autologous bone marrow transplantation
Fernanda Belloni dos Santos Nogueira1, Suzana Alves Silva, Andrea Ferreira Haddad
1Hospital Pró-Cardíaco, Rio de Janeiro, RJ, Brasil. fernandabnogueira@uol.com.br
Insights
Autologous mononuclear bone marrow cell transplantation did not improve systolic function in patients with acute myocardial infarction. This study found no significant echocardiographic differences between cell therapy routes and a control group.
Area of Science:
- Cardiology
- Regenerative Medicine
- Stem Cell Therapy
Background:
- Controversial findings exist regarding bone marrow stem cells' effect on left ventricle remodeling post-myocardial infarction.
- Evaluating autologous mononuclear bone marrow cell transplantation (AMBMCT) for post-acute myocardial infarction (MI) recovery is crucial.
Purpose of the Study:
- To conduct an echocardiographic analysis of systolic function in acute myocardial infarction patients following AMBMCT via intracoronary and intravenous routes.
Main Methods:
- Open-label, prospective, randomized study involving 30 ST-elevation MI patients.
- AMBMCT administered via intracoronary or intravenous routes (100 x 10^6 cells).
- Echocardiography assessed ventricular function pre- and post-infusion at 3 and 6 months.
Main Results:
- No statistically significant differences in echocardiographic parameters were observed between the arterial, venous, and control groups.
- The study included 14 patients in the arterial group, 10 in the venous group, and 6 in the control group.
Conclusions:
- Autologous mononuclear bone marrow cell transplantation did not demonstrate improvement in echocardiographic parameters of systolic function.
- Further research may be needed to explore alternative cell types or delivery methods for post-MI cardiac repair.
Background:
Several studies have been published on the effect of bone-marrow stem cells on the left ventricle when acting on post- acute myocardial infarction remodeling. However, the results have been controversial.
Objective:
To carry out an echocardiographic analysis of the systolic function of patients with acute myocardial infarction after autologous mononuclear bone marrow cell transplantation (AMBMCT) as performed via the intracoronary and intravenous routes.
Methods:
This is an open-label, prospective, randomized study.
Inclusion Criteria:
patients admitted for ST-elevation acute myocardial infarction (MI) who had undergone mechanical or chemical reperfusion within 24 hours of the onset of symptoms and whose echocardiogram showed decreased segmental wall motion and fixed perfusion defect related to the culprit artery. Autologous bone marrow was aspirated from the posterior iliac crest under sedation and analgesia of the patients randomly assigned for the treatment group. After laboratory manipulation, intracoronary or intravenous injection of 100 x 106 mononuclear cells was performed. Echocardiography (Vivid 7) was used to assess ventricular function before and three and six months after cell infusion.
Results:
A total of 30 patients were included, 14 in the arterial group (AG), 10 in the venous group (VG), and six in the control group (CG). No statistical difference was found between the groups for the echocardiographic parameters studied.
Conclusion:
Autologous mononuclear bone marrow cell transplantation did not improve the echocardiographic parameters of systolic function.
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