Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, Leiden, The Netherlands.
Circ Cardiovasc Imaging. 2011 Mar;4(2):122-9. doi: 10.1161/CIRCIMAGING.110.957548. Epub 2011 Jan 5.
The present substudy of a recently published randomized trial aimed to investigate the effect of intramyocardial bone marrow cell injection on diastolic function in patients with chronic myocardial ischemia.
In a total of 50 patients, diastolic function was evaluated before and 3 months after bone marrow cell injection using standard echocardiography and strain analysis. In addition, MRI-derived transmitral flow measurements were obtained in a subset of 36 patients. Left ventricular ejection fraction increased from 50±5% to 54±7% in the bone marrow cell group, which was a significant improvement as compared with the placebo group (52±5% versus 51±7%, P=0.001). Filling pressure estimate E/E' ratio improved from 14±5 at baseline to 12±4 at 3 months in the bone marrow cell group, whereas no improvement was observed in the placebo group (13±4 versus 13±5). The improvement in E/E' ratio was significantly larger in the bone marrow cell group (P=0.008). Furthermore, the E/A peak flow ratio as assessed by MRI showed a significant increase in the bone marrow cell group as compared with the placebo group (+0.16±0.25 versus -0.04±0.21, P=0.01), which was mainly related to an increase in the early (E) peak flow rate in the bone marrow cell group (from 407±96 mL/s to 468±110 mL/s, P=0.009 as compared with the placebo group).
The current study demonstrates that intramyocardial bone marrow cell injection is associated with a beneficial effect on myocardial relaxation and filling pressures in patients with chronic myocardial ischemia.
本研究是对最近发表的一项随机试验的子研究，旨在探讨心肌内骨髓细胞注射对慢性心肌缺血患者舒张功能的影响。
在总共 50 例患者中，使用标准超声心动图和应变分析在骨髓细胞注射前和 3 个月后评估舒张功能。此外，在 36 例患者亚组中获得了 MRI 衍生的经二尖瓣血流测量值。骨髓细胞组的左心室射血分数从 50±5%增加到 54±7%，与安慰剂组相比有显著改善（52±5%比 51±7%，P=0.001）。骨髓细胞组的充盈压估计 E/E' 比值从基线时的 14±5 改善至 3 个月时的 12±4，而安慰剂组无改善（13±4 比 13±5）。骨髓细胞组的 E/E' 比值改善明显更大（P=0.008）。此外，MRI 评估的 E/A 峰值血流比在骨髓细胞组与安慰剂组相比显示出显著增加（+0.16±0.25 比-0.04±0.21，P=0.01），这主要与骨髓细胞组的早期（E）峰值血流率增加有关（从 407±96 mL/s 增加至 468±110 mL/s，与安慰剂组相比，P=0.009）。
本研究表明，心肌内骨髓细胞注射与慢性心肌缺血患者心肌松弛和充盈压的有益作用相关。
