Lipiec Piotr, Krzemińska-Pakuła Maria, Plewka Michał, Kuśmierek Jacek, Płachcińska Anna, Szumiński Remigiusz, Robak Tadeusz, Korycka Anna, Kasprzak Jarosław D
2nd Department of Cardiology, Medical University of Łódź, Łódź, Poland.
Eur J Nucl Med Mol Imaging. 2009 Apr;36(4):587-93. doi: 10.1007/s00259-008-0988-6. Epub 2008 Nov 29.
We investigated the impact of intracoronary injection of autologous mononuclear bone marrow cells (BMC) in patients with acute ST elevation myocardial infarction (STEMI) on left ventricular volumes, global and regional systolic function and myocardial perfusion.
The study included 39 patients with first anterior STEMI treated successfully with primary percutaneous coronary intervention. They were randomly assigned to the treatment group or the control group in a 2:1 ratio. The patients underwent baseline gated single-photon emission computed tomography (G-SPECT) 3-10 days after STEMI with quantitative and qualitative analysis of left ventricular perfusion and systolic function. On the following day, patients from the BMC treatment group were subjected to bone marrow aspiration, mononuclear BMC isolation and intracoronary injection. No placebo procedure was performed in the control group. G-SPECT was repeated 6 months after STEMI.
Baseline and follow-up G-SPECT studies were available for 36 patients. At 6 months in the BMC group we observed a significantly enhanced improvement in the mean extent of the perfusion defect, the left ventricular perfusion score index, the infarct area perfusion score and the infarct area wall motion score index compared to the control group (p = 0.01-0.04). However, the changes in left ventricular volume, ejection fraction and the left ventricular wall motion score index as well as the relative changes in the infarct area wall motion score index did not differ significantly between the groups.
Intracoronary injection of autologous mononuclear BMC in patients with STEMI improves myocardial perfusion at 6 months. The benefit in infarct area systolic function is less pronounced and there is no apparent improvement of global left ventricular systolic function.
我们研究了急性ST段抬高型心肌梗死（STEMI）患者冠状动脉内注射自体单核骨髓细胞（BMC）对左心室容积、整体和局部收缩功能以及心肌灌注的影响。
该研究纳入了39例首次发生前壁STEMI且经直接经皮冠状动脉介入治疗成功的患者。他们以2:1的比例被随机分配至治疗组或对照组。患者在STEMI后3 - 10天接受基线门控单光子发射计算机断层扫描（G-SPECT），对左心室灌注和收缩功能进行定量和定性分析。次日，BMC治疗组的患者接受骨髓穿刺、单核BMC分离及冠状动脉内注射。对照组未进行安慰剂操作。STEMI后6个月重复进行G-SPECT检查。
36例患者有基线和随访G-SPECT研究数据。与对照组相比，在BMC组6个月时，我们观察到灌注缺损的平均范围、左心室灌注评分指数、梗死区域灌注评分及梗死区域壁运动评分指数有显著增强的改善（p = 0.01 - 0.04）。然而，两组间左心室容积、射血分数及左心室壁运动评分指数的变化，以及梗死区域壁运动评分指数的相对变化并无显著差异。
STEMI患者冠状动脉内注射自体单核BMC可在6个月时改善心肌灌注。对梗死区域收缩功能的益处不太明显，且左心室整体收缩功能无明显改善。
