急性心肌梗死后患者行冠状动脉内骨髓细胞移植对心脏舒张功能的影响:BOOST试验之结果

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Aims: We have recently shown in the randomized-controlled BOne marrOw transfe r to enhance ST-elevation infarct regeneration(BOOST) trial that intracoronary autologous bone marrow cell(BMC) transfer improves left ventricular(LV) ejection fraction recovery in patients after acute myocardial infarction(AMI). However, the impact of BMC therapy on LV diastolic function in patients after AMI has rem ained uncertain. Methods and results: Using(tissue) Doppler echocardiography, we evaluated the effects of BMC transfer on LV diastolic function in patients enro lled in the BOOST trial. After successful primary percutaneous coronary interven tion(PCI) for acute ST-elevation myocardial infarction(MI), patients were rando mized to a control(n=29) or BMC transfer group(n=30). Diastolic function was det ermined 4.5±1.5 days after PCI, at 6 months, and at 18 months by measuring tran smitral flow velocities(E/A ratio), diastolic myocardial velocities(Ea/Aa ratio) , isovolumic relaxation time(IVRT), and deceleration time(DT). All analyses were performed in a blinded fashion. There was an overall effect of BMC transfer on E/A [0.33±0.12; 95%confidence interval(CI): 0.09-0.57; P=0.008] and Ea/Aa rat ios(0.29±0.14; 95%CI: 0.01-0.57;P=0.04). In contrast, we found no effect of B MC transfer on DT(-5±14 ms; 95%CI: -33 to 22; P=0.70), IVRT(-7±7 ms; 95%C I: -20 to 6; P=0.29), and E/Ea ratio(0.35±0.14; 95%CI: -0.92 to 1.62; P=0.57 ). Conclusion: Intracoronary autologous BMC transfer improves echocardiographic parameters of diastolic function in patients after AMI. Aims: We have recently shown in the randomized-controlled BOne marrOw transfe r to enhance ST-elevation infarct regeneration (BOOST) trial that intracoronary autologous bone marrow cell (BMC) transfer improves left ventricular (LV) ejection fraction recovery in patients after acute myocardial ischemia However, the impact of BMC therapy on LV diastolic function in patients after AMI has rem ained uncertain. Methods and results: Using (tissue) Doppler echocardiography, we evaluated the effects of BMC transfer on LV diastolic function in patients enro After successful primary percutaneous coronary intervention (PCI) for acute ST-elevation myocardial infarction (MI), patients were rando mized to a control (n = 29) or BMC transfer group (n = 30) function was detmined 4.5 ± 1.5 days after PCI, at 6 months, and at 18 months by measured tran smitral flow velocities (E / A ratio), diastolic myocardial velocities (Ea / Aa ratio), isovolumic relaxation time (IVRT), a There was an overall effect of BMC transfer on E / A [0.33 ± 0.12; 95% confidence interval (CI): 0.09-0.57; P = 0.008] and In contrast, we found no effect of B MC transfer on DT (-5 ± 14 ms; 95% CI: -33 to P = 0.70), IVRT (-7 ± 7 ms; 95% CI: -20 to 6; P = 0.29), and E / Ea ratio (0.35 ± 0.14; 95% CI: -0.92 to 1.62; P = 0.57). Conclusion: Intracoronary autologous BMC transfer improves echocardiographic parameters of diastolic function in patients after AMI.
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