Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
JACC Cardiovasc Interv. 2011 Aug;4(8):913-20. doi: 10.1016/j.jcin.2011.05.005.
In the present substudy of the Hebe trial, we investigated the effect of intracoronary bone marrow mononuclear cell (BMMC) and peripheral blood mononuclear cell (PBMC) therapy on the recovery of microcirculation in patients with reperfused ST-segment elevation myocardial infarction (STEMI).
Several studies have suggested that cell therapy enhances neovascularization after STEMI.
Paired Doppler flow measurements were available for 23 patients in the BMMC group, 18 in the PBMC group, and 19 in the control group. Coronary flow was assessed at 3 to 8 days after primary percutaneous coronary intervention (PCI) and repeated at 4-month follow-up, with intracoronary Doppler flow measurements.
At baseline, the coronary flow velocity reserve was reduced in the infarct-related artery and improved over 4 months in all 3 groups. The increase of coronary flow velocity reserve did not significantly differ between the 2 treatment groups and the control group (BMMC group: 2.0 ± 0.5 to 3.1 ± 0.7; PBMC group: 2.2 ± 0.6 to 3.2 ± 0.8; control group: 2.0 ± 0.5 to 3.4 ± 0.9). Additionally, the decrease in hyperemic microvascular resistance index from baseline to 4-month follow-up was not statistically different between the 2 treatment groups and the control group.
In STEMI patients treated with primary PCI in the Hebe trial, adjuvant therapy with BMMCs or PBMCs does not improve the recovery of microcirculation. Therefore, our data do not support the hypothesis of enhanced neovascularization after this mode of cell therapy. (Multicenter, randomised trial of intracoronary infusion of autologous mononuclear bone marrow cells or peripheral mononuclear blood cells after primary percutaneous coronary intervention [PCI]; ISRCTN95796863).
在 Hebe 试验的本次亚组研究中，我们研究了经皮冠状动脉介入治疗（PCI）后冠状动脉内骨髓单个核细胞（BMMC）和外周血单个核细胞（PBMC）治疗对再灌注 ST 段抬高型心肌梗死（STEMI）患者微循环恢复的影响。
多项研究表明，细胞治疗可增强 STEMI 后的新生血管形成。
BMMC 组 23 例、PBMC 组 18 例和对照组 19 例患者可进行配对多普勒血流测量。在初次 PCI 后 3 至 8 天进行冠状动脉血流评估，并在 4 个月随访时进行冠状动脉内多普勒血流测量。
在基线时，梗死相关动脉的冠状动脉血流速度储备降低，在所有 3 组中均在 4 个月时得到改善。2 个治疗组和对照组之间，冠状动脉血流速度储备的增加无显著差异（BMMC 组：2.0±0.5 至 3.1±0.7；PBMC 组：2.2±0.6 至 3.2±0.8；对照组：2.0±0.5 至 3.4±0.9）。此外，从基线到 4 个月随访时，高血流量微血管阻力指数的下降在 2 个治疗组和对照组之间无统计学差异。
在 Hebe 试验中接受初次 PCI 治疗的 STEMI 患者中，辅助使用 BMMC 或 PBMC 治疗不能改善微循环的恢复。因此，我们的数据不支持这种细胞治疗方式后新生血管形成增强的假说。（多中心、随机试验，在初次经皮冠状动脉介入治疗（PCI）后冠状动脉内输注自体单个核骨髓细胞或外周单个核血细
