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在大面积前壁心肌梗死患者中,经自体冠状动脉内单核骨髓细胞移植后心肌未能再生。

Lack of regeneration of myocardium by autologous intracoronary mononuclear bone marrow cell transplantation in humans with large anterior myocardial infarctions.

作者信息

Kuethe Friedhelm, Richartz Barbara M, Sayer Herbert G, Kasper Christoph, Werner Gerald S, Höffken Klaus, Figulla Hans R

机构信息

Klinik fuer Innere Medizin I, Friedrich-Schiller-Universitaet Jena, Erlanger Allee 101, 07740 Jena, Germany.

出版信息

Int J Cardiol. 2004 Oct;97(1):123-7. doi: 10.1016/j.ijcard.2004.05.002.

Abstract

BACKGROUND

Experimental and preliminary clinical data suggest that transplantation of autologous bone marrow cells (BMC) may contribute to regeneration of the myocardium after acute myocardial infarction. This approach should be tested in patients with large infarctions in whom a positive effect would be most beneficial.

METHODS AND RESULTS

After successful recanalization within 5.9 +/- 2.5 h and stent implantation in five patients with a large acute anterior myocardial infarction (AMI), the patients received autologous mononuclear BMCs via a balloon catheter placed into the left anterior descending artery 6.3 +/- 0.4 days after revascularization. At 3-month follow-up, no improvement was observed for left ventricular ejection fraction, regional wall motion in the infarcted zone, contractility index measured via dobutamine stress echocardiography, coronary blood flow reserve and maximal oxygen uptake, respectively. After further follow-up of 12 months, again no change of the left ventricular ejection fraction could be detected.

CONCLUSIONS

Intracoronary transplantation of autologous mononuclear BMCs did not improve cardiac function in our patients with large anterior myocardial infarctions after 3 and 12 months.

摘要

背景

实验及初步临床数据表明,自体骨髓细胞(BMC)移植可能有助于急性心肌梗死后心肌的再生。这种方法应在大面积梗死患者中进行测试,因为在这类患者中产生积极效果将最为有益。

方法与结果

5例大面积急性前壁心肌梗死(AMI)患者在5.9±2.5小时内成功再灌注并植入支架,血运重建后6.3±0.4天,通过置于左前降支的球囊导管给予患者自体单个核BMC。在3个月随访时,左心室射血分数、梗死区域的室壁运动、通过多巴酚丁胺负荷超声心动图测量的收缩性指数、冠状动脉血流储备及最大摄氧量均未改善。在进一步随访12个月后,仍未检测到左心室射血分数有变化。

结论

在我们的大面积前壁心肌梗死患者中,冠状动脉内移植自体单个核BMC在3个月及12个月后均未改善心脏功能。

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