Beeres Saskia L M A, Bax Jeroen J, Kaandorp Theodorus A M, Zeppenfeld Katja, Lamb Hildo J, Dibbets-Schneider Petra, Stokkel Marcel P M, Fibbe Willem E, de Roos Albert, van der Wall Ernst E, Schalij Martin J, Atsma Douwe E
Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
Am J Cardiol. 2006 May 1;97(9):1326-31. doi: 10.1016/j.amjcard.2005.11.068. Epub 2006 Mar 20.
Bone marrow cell transplantation has been proposed as a novel therapeutic option for patients with coronary artery disease. This study investigated whether autologous bone marrow-derived mononuclear cell injection into the ischemic myocardium of patients with severe angina pectoris could safely reduce anginal symptoms, improve myocardial perfusion, and increase left ventricular (LV) function. In a total of 20 patients (63 +/- 10 years old; 16 men) with angina pectoris, myocardial segments with stress-induced ischemia as assessed by gated single-photon emission computed tomography were injected with 30 to 100 million mononuclear cells. Anginal symptoms, Canadian Cardiovascular Society class, and quality of life were assessed at 3 and 6 months of follow-up. At baseline and 3 months of follow-up, an exercise test, gated single-photon emission computed tomography, and magnetic resonance imaging were performed to assess exercise capacity, myocardial perfusion, and LV function. Intramyocardial injection of autologous bone marrow-derived mononuclear cells was safe. The Canadian Cardiovascular Society class improved from 3.5 +/- 0.5 at baseline to 2.4 +/- 0.6 after 3 months (p <0.01) and 2.4 +/- 0.6 after 6 months (p <0.01). The quality-of-life score improved from 52 +/- 10% to 71 +/- 10% at 3 months (p <0.01) to 73 +/- 15% at 6 months (p <0.01). The exercise capacity increased from 79 +/- 31% to 84 +/- 29% (p <0.05). Magnetic resonance imaging revealed an increased LV ejection fraction from 51 +/- 11% to 54 +/- 10% (p <0.01) and a reduced LV end-systolic volume from 97 +/- 50 to 88 +/- 42 ml (p <0.01). The wall motion score index improved from 0.36 +/- 0.32 to 0.24 +/- 0.28 (p <0.01). The number of segments with stress-induced ischemia decreased from 5.1 +/- 3.2 to 2.3 +/- 2.6 (p<0.01). In conclusion, autologous bone marrow-derived mononuclear cell injection in patients with ischemia is safe, reduces anginal symptoms, improves myocardial perfusion, and increases LV function.
骨髓细胞移植已被提议作为冠心病患者的一种新型治疗选择。本研究调查了将自体骨髓来源的单个核细胞注射到严重心绞痛患者的缺血心肌中是否能安全减轻心绞痛症状、改善心肌灌注并增强左心室（LV）功能。在总共20例心绞痛患者（年龄63±10岁；16例男性）中，通过门控单光子发射计算机断层扫描评估有应激诱导缺血的心肌节段被注射了3000万至1亿个单个核细胞。在随访的3个月和6个月时评估心绞痛症状、加拿大心血管学会分级和生活质量。在基线和随访3个月时，进行运动试验、门控单光子发射计算机断层扫描和磁共振成像以评估运动能力、心肌灌注和LV功能。心肌内注射自体骨髓来源的单个核细胞是安全的。加拿大心血管学会分级从基线时的3.5±0.5改善至3个月后的2.4±0.6（p<0.01）和6个月后的2.4±0.6（p<0.01）。生活质量评分从3个月时的52±10%提高至71±10%（p<0.01），6个月时提高至73±15%（p<0.01）。运动能力从79±31%提高至84±29%（p<0.05）。磁共振成像显示LV射血分数从51±11%增加至54±10%（p<0.01），LV收缩末期容积从97±50减少至88±42 ml（p<0.01）。室壁运动评分指数从0.36±0.32改善至0.24±0.28（p<0.01）。应激诱导缺血的节段数量从5.1±3.2减少至2.3±2.6（p<
0.01）。总之，则缺血患者中注射自体骨髓来源的单个核细胞是安全的，可减轻心绞痛症状、改善心肌灌注并增强LV功能。
