Cardiology Division, Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong.
J Cardiovasc Magn Reson. 2010 Jan 25;12(1):6. doi: 10.1186/1532-429X-12-6.
Recent studies suggested that bone marrow (BM) cell implantation in patients with severe chronic coronary artery disease (CAD) resulted in modest improvement in symptoms and cardiac function. This study sought to investigate the functional changes that occur within the chronic human ischaemic myocardium after direct endomyocardial BM cells implantation by cardiovascular magnetic resonance (CMR).
We compared the interval changes of left ventricular ejection fraction (LVEF), myocardial perfusion reserve and the extent of myocardial scar by using late gadolinium enhancement CMR in 12 patients with severe CAD. CMR was performed at baseline and at 6 months after catheter-based direct endomyocardial autologous BM cell (n = 12) injection to viable ischaemic myocardium as guided by electromechanical mapping. In patients randomized to receive BM cell injection, there was significant decrease in percentage area of peri-infarct regions (-23.6%, P = 0.04) and increase in global LVEF (+9.0%, P = 0.02), the percentage of regional wall thickening (+13.1%, P= 0.04) and MPR (+0.25%, P = 0.03) over the target area at 6-months compared with baseline.
Direct endomyocardial implantation of autologous BM cells significantly improved global LVEF, regional wall thickening and myocardial perfusion reserve, and reduced percentage area of peri-infarct regions in patients with severe CAD.
最近的研究表明，骨髓（BM）细胞移植可改善严重慢性冠状动脉疾病（CAD）患者的症状和心功能。本研究旨在通过心血管磁共振（CMR）检测慢性人类缺血性心肌内直接心肌内 BM 细胞移植后发生的功能变化。
我们比较了 12 例严重 CAD 患者在基线和经皮直接心肌内自体 BM 细胞（n = 12）注射后 6 个月时左心室射血分数（LVEF）、心肌灌注储备和心肌瘢痕范围的间隔变化，由电机械映射指导的缺血存活心肌。在接受 BM 细胞注射的患者中，与基线相比，梗死周边区域的百分比面积（-23.6%，P = 0.04）和全球 LVEF（+9.0%，P = 0.02）、局部壁增厚百分比（+13.1%，P= 0.04）和 MPR（+0.25%，P = 0.03）在目标区域均显著增加。
直接心肌内自体 BM 细胞移植可显著改善严重 CAD 患者的整体 LVEF、局部壁增厚和心肌灌注储备，并减少梗死周边区域的百分比面积。
