慢性冠状动脉疾病中经冠状动脉自体骨髓细胞移植对人类梗死心肌的再生作用：IACT研究

Regeneration of human infarcted heart muscle by intracoronary autologous bone marrow cell transplantation in chronic coronary artery disease: the IACT Study.

作者信息

Strauer Bodo E, Brehm Michael, Zeus Tobias, Bartsch Thomas, Schannwell Christina, Antke Christine, Sorg Rüdiger V, Kögler Gesine, Wernet Peter, Müller Hans-Wilhelm, Köstering Matthias

机构信息

Department of Internal Medicine, Division of Cardiology, Pneumology and Angiology, Heinrich-Heine-University, Düsseldorf, Germany.

出版信息

J Am Coll Cardiol. 2005 Nov 1;46(9):1651-8. doi: 10.1016/j.jacc.2005.01.069.

DOI:10.1016/j.jacc.2005.01.069

PMID:16256864

Abstract

OBJECTIVES

Stem cell therapy may be useful in chronic myocardial infarction (MI); this is conceivable, but not yet demonstrated in humans.

BACKGROUND

After acute MI, bone marrow-derived cells improve cardiac function.

METHODS

We treated 18 consecutive patients with chronic MI (5 months to 8.5 years old) by the intracoronary transplantation of autologous bone marrow mononuclear cells and compared them with a representative control group without cell therapy.

RESULTS

After three months, in the transplantation group, infarct size was reduced by 30% and global left ventricular ejection fraction (+15%) and infarction wall movement velocity (+57%) increased significantly, whereas in the control group no significant changes were observed in infarct size, left ventricular ejection fraction, or wall movement velocity of infarcted area. Percutaneous transluminal coronary angioplasty alone had no effect on left ventricular function. After bone marrow cell transplantation, there was an improvement of maximum oxygen uptake (VO2max, +11%) and of regional 18F-fluor-desoxy-glucose uptake into infarct tissue (+15%).

CONCLUSIONS

These results demonstrate that functional and metabolic regeneration of infarcted and chronically avital tissue can be realized in humans by bone marrow mononuclear cell transplantation.

摘要

目的

干细胞疗法可能对慢性心肌梗死（MI）有效；这是可以想象的，但尚未在人体中得到证实。

背景

急性心肌梗死后，骨髓来源的细胞可改善心脏功能。

方法

我们对18例连续的慢性心肌梗死患者（年龄5个月至8.5岁）进行了自体骨髓单个核细胞冠状动脉内移植治疗，并将其与未进行细胞治疗的代表性对照组进行比较。

结果

三个月后，移植组梗死面积减少30%，左心室整体射血分数（增加15%）和梗死壁运动速度（增加57%）显著增加，而对照组梗死面积、左心室射血分数或梗死区域壁运动速度均未观察到显著变化。单纯经皮腔内冠状动脉成形术对左心室功能无影响。骨髓细胞移植后，最大摄氧量（VO2max，增加11%）和梗死组织区域18F-氟脱氧葡萄糖摄取（增加15%）有所改善。