Tendera Michal, Wojakowski Wojciech
Eur J Echocardiogr. 2010 Jun;11(5):438-9. doi: 10.1093/ejechocard/jeq025. Epub 2010 Mar 22.
The results of clinical studies showed that there is a moderate increase in left ventricular (LV) ejection fraction (EF) at 4-6 months after stem cell therapy. So far, the endpoint of such trials was the change of LVEF and volumes measured by LV angiography or MRI; however, these parameters might not be optimal to assess the effects of BMC therapy. BOOST trial was one of the first studies addressing the effect of bone marrow cell transfer in patients with acute ST-elevation myocardial infarction. The results of 5-year follow-up were reported, showed no sustained effect on the LV systolic function in the whole group, but some beneficial effects on diastolic function were found. Other study showed using tissue-Doppler that after implantation of selected CD133+ and CD133-CD34+ bone marrow-derived cells in patients with history of anterior MI and severely reduced LVEF the indices of regional LV systolic function improved. Clinical significance of these findings remains to be established; however, the assessment of diastolic function and tissue-Doppler imaging might be valuable parameters in stem cell-based trials.
临床研究结果表明，干细胞治疗后4至6个月，左心室（LV）射血分数（EF）有适度增加。到目前为止，此类试验的终点是通过左心室血管造影或磁共振成像测量的左心室射血分数和容积的变化；然而，这些参数可能并非评估骨髓单个核细胞治疗效果的最佳指标。BOOST试验是最早探讨骨髓细胞移植对急性ST段抬高型心肌梗死患者疗效的研究之一。该试验报告了5年随访结果，显示对整个组的左心室收缩功能无持续影响，但发现对舒张功能有一些有益作用。另一项研究使用组织多普勒显示，在有前壁心肌梗死病史且左心室射血分数严重降低的患者中，植入选定的CD133+和CD133-CD34+骨髓来源细胞后，左心室区域收缩功能指标有所改善。这些发现的临床意义仍有待确定；然而，舒张功能评估和组织多普勒成像可能是基于干细胞试验中的有价值参数。
