Srimahachota Suphot, Boonyaratavej Smonporn, Rerkpattanapipat Pairoj, Wangsupachart Somjai, Tumkosit Monravee, Bunworasate Udomsak, Nakorn Thayapong Na, Intragumtornchai Tanin, Kupatawintu Pawinee, Pongam Sunisa, Saengsiri Aem-Orn, Pothisri Mantana, Sukseri Yeesoon, Bunprasert Tanorm, Suithichaiyakul Taworn
Division of Cardiology, Department of Medicine, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
J Med Assoc Thai. 2011 Jun;94(6):657-63.
Stem cell transplantation is a potential treatment to improve left ventricular ejection fraction (LVEF) after ST elevation myocardial infarction (STEMI). However, the outcomes still are controversial.
To determine the 6-month LVEF of the patients who underwent intra-coronary bone marrow mononuclear cell (BMC) transplantation in patients with STEMI compared with controlled subjects.
After successful percutaneous coronary intervention (PCI) in STEMI patients who had LVEF was less than 50% were randomized to intra-coronary BMC transplantation or control. Bone marrow aspiration of 100 cc was performed in the morning. After cellprocessing for three hours, the suspension of BMC about 10 cc were infused to infracted area using standard PCI technique. Balloon occlusion for three minutes was performed during cell infusion. Cardiac magnetic resonance imaging was used to determine LVEF scar volume and LV volume before and six-month follow-up.
Between September 2006 and July 2008, 23patients (11 in BMC group and 12 in control group) were enrolled. Mean BMC count before transplant was 420 x 10(6) cell with 96% viability. At six-month follow-up, New York Heart Association function class significantly improved in both groups (2.3 +/- 0.6 to 1.2 +/- 0. 4 for BMC and 2.3 +/- 0.7 to 1.3 +/- 0.5 for control group) but no difference was seen between groups. However, scar volume, wall motion score index, and LVEF did not show improvement after six months in both groups (33.7 +/- 7.7 to 33.5 +/- 7.6 for BMC and 31.1 +/- 7.1 to 32.6 +/- 8.3 for control group). No complication was observed during the procedure.
BMC transplantation intra-coronary in patients with STEMI in KCMH was feasible and safe but LVEF improvement could not be demonstrated.
干细胞移植是改善ST段抬高型心肌梗死（STEMI）后左心室射血分数（LVEF）的一种潜在治疗方法。然而，其结果仍存在争议。
确定与对照组相比，接受冠状动脉内骨髓单个核细胞（BMC）移植的STEMI患者的6个月LVEF。
对LVEF小于50%的STEMI患者成功进行经皮冠状动脉介入治疗（PCI）后，随机分为冠状动脉内BMC移植组或对照组。于上午采集100 cc骨髓。细胞处理3小时后，使用标准PCI技术将约10 cc的BMC悬液注入梗死区域。细胞输注期间进行3分钟的球囊闭塞。在基线和6个月随访时使用心脏磁共振成像来确定LVEF、瘢痕体积和左心室容积。
2006年9月至2008年7月期间，共纳入23例患者（BMC组11例，对照组12例）。移植前BMC平均计数为420×10⁶个细胞，活力为96%。在6个月随访时，两组纽约心脏协会功能分级均显著改善（BMC组从2.3±0.6改善至1.2±0.4，对照组从2.3±0.7改善至1.3±0.5），但两组间无差异。然而，两组在6个月后瘢痕体积、壁运动评分指数和LVEF均未显示改善（BMC组从33.7±7.7至33.5±7.6，对照组从31.1±7.1至32.6±8.3）。术中未观察到并发症。
在KCMH医院，STEMI患者冠状动脉内BMC移植是可行且安全的，但未能证明LVEF有所改善。
