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European Heart Journal Advance Access published online on December 23, 2008
European Heart Journal, doi:10.1093/eurheartj/ehn532
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

Improved regional function after autologous bone marrow-derived stem cell transfer in patients with acute myocardial infarction: a randomized, double-blind strain rate imaging study

Lieven Herbots1,*, Jan D'hooge1, Elif Eroglu1, Daisy Thijs1, Javier Ganame1, Piet Claus1, Christophe Dubois1, Koen Theunissen2, Jan Bogaert3, Joseph Dens1, Maria Kalantzi3, Steven Dymarkowski3, Bart Bijnens1, Ann Belmans1, Marc Boogaerts2,4, George Sutherland1, Frans Van de Werf1, Frank Rademakers1 and Stefan Janssens1,5

1 Department of Cardiology, Gasthuisberg University Hospital, University of Leuven, 49 Herestraat, B-3000 Leuven, Belgium
2 Department of Haematology, Gasthuisberg University Hospital, University of Leuven, Leuven, Belgium
3 Department of Radiology, Gasthuisberg University Hospital, University of Leuven, Leuven, Belgium
4 The Stem Cell Institute Leuven (SCIL), Gasthuisberg University Hospital, University of Leuven, Leuven, Belgium
5 The Centre for Transgene Technology and Gene Therapy, Gasthuisberg University Hospital, University of Leuven, Leuven, Belgium

Received 25 April 2007; revised 23 October 2008; accepted 18 November 2008.

* Corresponding author. Tel: +32 16 344235, Fax: +32 16 344240, Email: lieven.herbots{at}uz.kuleuven.ac.be

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.

Key Words: Stem cell therapy • Regional myocardial function • Strain rate imaging • Acute myocardial infarction

This paper was guest edited by Prof. Cassiano Abreu e Lima, Porto School of Medicine, Al. Hernâni Monteiro, Porto, Portugal, email: assal{at}hsjoo.min-saude.pt; cassal{at}netcabo.pt


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