Lunde Ketil, Solheim Svein, Aakhus Svend, Arnesen Harald, Moum Torbjørn, Abdelnoor Michael, Egeland Torstein, Endresen Knut, Ilebekk Arnfinn, Mangschau Arild, Forfang Kolbjørn
Department of Cardiology, Rikshospitalet-Radiumhospitalet University Hospital, Oslo, Norway.
Am Heart J. 2007 Oct;154(4):710.e1-8. doi: 10.1016/j.ahj.2007.07.003.
The effects on left ventricular function of intracoronary injection of bone marrow cells in acute myocardial infarction (AMI) have been studied with conflicting results. The aim of this substudy of the ASTAMI trial was to examine the effects of this novel treatment on exercise capacity and quality of life.
We studied 100 patients with anterior wall ST-elevation AMI. All had percutaneous coronary intervention with stent in the proximal or mid left anterior descending coronary artery 2 to 12 hours after start of symptoms. Patients were randomized to intracoronary injection of mononuclear bone marrow cells (mBMCs) in left anterior descending coronary artery 6 +/- 1.3 days after AMI (n = 50) or control (n = 50). Assessment of physical capacity by maximal symptom-limited bicycle ergometer exercise tests and quality of life by the Short Form 36 health survey was performed 2 to 3 weeks and 6 months after the AMI.
There was a significantly greater improvement in exercise time in the mBMC group than in the control group (treatment effect 0.9 minute, 95% CI 0.3-1.6, P < .01), and a similar improvement in peak oxygen consumption in the groups (2.8 +/- 3.9 mL/[kg min] in the mBMC group vs 2.4 +/- 3.5 mL/[kg min] in controls, P = .62). Peak heart rate and percentage of heart rate reserve increased significantly more in the treatment group than in the control group. Treatment with mBMCs did not influence quality of life.
In this randomized open-labeled study, the mBMC group significantly improved exercise time and heart rate responses to exercise compared with the control group. There was no treatment effect on peak oxygen consumption.
冠状动脉内注射骨髓细胞对急性心肌梗死（AMI）患者左心室功能的影响已得到研究，但结果相互矛盾。本ASTAMI试验子研究的目的是探讨这种新疗法对运动能力和生活质量的影响。
我们研究了100例前壁ST段抬高型AMI患者。所有患者在症状发作后2至12小时均接受了经皮冠状动脉介入治疗，并在左前降支冠状动脉近端或中段置入支架。患者被随机分为两组，一组在AMI后6±1.3天接受冠状动脉内注射单核骨髓细胞（mBMCs）（n = 50），另一组为对照组（n = 50）。在AMI后2至3周和6个月时，通过症状限制的最大运动平板试验评估身体能力，并通过简短健康调查问卷36评估生活质量。
mBMC组的运动时间改善显著大于对照组（治疗效果为0.9分钟，95%CI为0.3 - 1.6，P <.01），两组的峰值耗氧量有相似改善（mBMC组为2.8±3.9 mL/[kg·min]，对照组为2.4±3.5 mL/[kg·min]，P =.62）。治疗组的峰值心率和心率储备百分比增加显著多于对照组。mBMCs治疗对生活质量无影响。
在这项随机开放标签研究中，与对照组相比，mBMC组显著改善了运动时间和运动时的心率反应。对峰值耗氧量无治疗效果。
