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European Heart Journal Advance Access published online on March 1, 2006
European Heart Journal, doi:10.1093/eurheartj/ehi817
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European Heart Journal © The European Society of Cardiology 2006; all rights reserved
Received November 25, 2005
Revised January 31, 2006
Accepted February 9, 2006

Clinical research

Impact of intracoronary bone marrow cell transfer on diastolic function in patients after acute myocardial infarction: results from the BOOST trial

Arnd Schaefer 1 *, Gerd P. Meyer 2, Martin Fuchs 2, Gunnar Klein 2, Marina Kaplan 2, Kai C. Wollert 2, and Helmut Drexler 2

1 Department of Cardiology and Angiology, Hannover Medical School, Abt. Kardiologie und Angiologie, Medizinische Hochschule Hannover, Carl-Neuberg Str. 1, 30625 Hannover, Germany
2 Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany

* To whom correspondence should be addressed.
Arnd Schaefer, E-mail: schaefer.arnd{at}mh-hannover.de


  Abstract

Aims We have recently shown in the randomized-controlled BOne marrOw transfer to enhance ST-elevation infarct regeneration (BOOST) trial that intracoronary autologous bone marrow cell (BMC) transfer improves left ventricular (LV) ejection fraction recovery in patients after acute myocardial infarction (AMI). However, the impact of BMC therapy on LV diastolic function in patients after AMI has remained uncertain.

Methods and results Using (tissue) Doppler echocardiography, we evaluated the effects of BMC transfer on LV diastolic function in patients enrolled in the BOOST trial. After successful primary percutaneous coronary intervention (PCI) for acute ST-elevation myocardial infarction (MI), patients were randomized to a control (n = 29) or BMC transfer group (n = 30). Diastolic function was determined 4.5 ± 1.5 days after PCI, at 6 months, and at 18 months by measuring transmitral flow velocities (E/A ratio), diastolic myocardial velocities (Ea/Aa ratio), isovolumic relaxation time (IVRT), and deceleration time (DT). All analyses were performed in a blinded fashion. There was an overall effect of BMC transfer on E/A [0.33 ± 0.12; 95% confidence interval (CI): 0.09-0.57; P = 0.008] and Ea/Aa ratios (0.29 ± 0.14; 95% CI: 0.01-0.57; P = 0.04). In contrast, we found no effect of BMC transfer on DT (-5 ± 14 ms; 95% CI: - 33 to 22; P = 0.70), IVRT (-7 ± 7 ms; 95% CI: - 20 to 6; P = 0.29), and E/Ea ratio (0.35 ± 0.14; 95% CI: - 0.92 to 1.62; P = 0.57).

Conclusion Intracoronary autologous BMC transfer improves echocardiographic parameters of diastolic function in patients after AMI.

Keywords: Bone marrow cell therapy; Diastolic function; Acute myocardial infarction.
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