BACKGROUND: The measurement of left ventricular (LV) ejection fraction (LVEF) is a strong predictor of cardiovascular adverse events and mortality in patients with LV dysfunction and has become the most common primary end point in cardiovascular cell therapy trials after ST-segment elevation myocardial infarction (STEMI). Multiple small trials have been performed using bone marrow mononuclear stem cells (BMCs) in this setting with several meta-analyses demonstrating that BMC administration results in a small improvement in LVEF and may attenuate adverse LV remodeling. However, individual trial results have not been uniform, and the measurement of LVEF in these trials has relied on a variety of imaging techniques including LV angiograpnhy, single-photon emission computed tomography, echocardiography, or cardiac magnetic resonance imaging (cMRI). METHODS: Because cMRI provides the most accurate measurement of LVEF, LV volumes, and infarct size in patients after STEMI, we reviewed all randomized cardiovascular stem cell trials (N = 10) that administered intracoronary BMCs versus placebo/control to 686 patients after primary percutaneous coronary intervention treatment of STEMI that used cMRI as their principal imaging measurement of LVEF at baseline and 3 to 6 months later. RESULTS: Administration of BMCs was associated with a nonsignificant 0.9% ± 0.8% absolute increase in LVEF compared with placebo or control (95% CI -0.7 to 2.4) with a small but nonsignificant decrease LV end-diastolic and LV end-systolic volumes (LV end-diastolic volume -1.1 ± 1.5 mL/m(2), LV end-systolic volume -1.6 ± 1.4 mL/m(2)). Although infarct size uniformly decreased over time, the reduction was not improved by BMC administration (-0.3 ± 1.7 g). CONCLUSIONS: The benefit of BMC administration after STEMI on LVEF, LV volumes, and infarct size is small when assessed by cMRI.
BACKGROUND: The measurement of left ventricular (LV) ejection fraction (LVEF) is a strong predictor of cardiovascular adverse events and mortality in patients with LV dysfunction and has become the most common primary end point in cardiovascular cell therapy trials after ST-segment elevation myocardial infarction (STEMI). Multiple small trials have been performed using bone marrow mononuclear stem cells (BMCs) in this setting with several meta-analyses demonstrating that BMC administration results in a small improvement in LVEF and may attenuate adverse LV remodeling. However, individual trial results have not been uniform, and the measurement of LVEF in these trials has relied on a variety of imaging techniques including LV angiograpnhy, single-photon emission computed tomography, echocardiography, or cardiac magnetic resonance imaging (cMRI). METHODS: Because cMRI provides the most accurate measurement of LVEF, LV volumes, and infarct size in patients after STEMI, we reviewed all randomized cardiovascular stem cell trials (N = 10) that administered intracoronary BMCs versus placebo/control to 686 patients after primary percutaneous coronary intervention treatment of STEMI that used cMRI as their principal imaging measurement of LVEF at baseline and 3 to 6 months later. RESULTS: Administration of BMCs was associated with a nonsignificant 0.9% ± 0.8% absolute increase in LVEF compared with placebo or control (95% CI -0.7 to 2.4) with a small but nonsignificant decrease LV end-diastolic and LV end-systolic volumes (LV end-diastolic volume -1.1 ± 1.5 mL/m(2), LV end-systolic volume -1.6 ± 1.4 mL/m(2)). Although infarct size uniformly decreased over time, the reduction was not improved by BMC administration (-0.3 ± 1.7 g). CONCLUSIONS: The benefit of BMC administration after STEMI on LVEF, LV volumes, and infarct size is small when assessed by cMRI.
Authors: Youngsook Lee; Arlo N McGinn; Curtis D Olsen; Kihoon Nam; Minhyung Lee; Sug Kyun Shin; Sung Wan Kim Journal: J Control Release Date: 2013-06-25 Impact factor: 9.776
Authors: Jay H Traverse; Timothy D Henry; Carl J Pepine; James T Willerson; Atul Chugh; Phillip C Yang; David X M Zhao; Stephen G Ellis; John R Forder; Emerson C Perin; Marc S Penn; Antonis K Hatzopoulos; Jeffrey C Chambers; Kenneth W Baran; Ganesh Raveendran; Adrian P Gee; Doris A Taylor; Lem Moyé; Ray F Ebert; Robert D Simari Journal: Circ Res Date: 2017-12-05 Impact factor: 17.367
Authors: Marco Zimarino; Mariangela D'Andreamatteo; Ron Waksman; Stephen E Epstein; Raffaele De Caterina Journal: Nat Rev Cardiol Date: 2014-01-07 Impact factor: 32.419
Authors: Jay H Traverse; Timothy D Henry; Stephen G Ellis; Carl J Pepine; James T Willerson; David X M Zhao; John R Forder; Barry J Byrne; Antonis K Hatzopoulos; Marc S Penn; Emerson C Perin; Kenneth W Baran; Jeffrey Chambers; Charles Lambert; Ganesh Raveendran; Daniel I Simon; Douglas E Vaughan; Lara M Simpson; Adrian P Gee; Doris A Taylor; Christopher R Cogle; James D Thomas; Guilherme V Silva; Beth C Jorgenson; Rachel E Olson; Sherry Bowman; Judy Francescon; Carrie Geither; Eileen Handberg; Deirdre X Smith; Sarah Baraniuk; Linda B Piller; Catalin Loghin; David Aguilar; Sara Richman; Claudia Zierold; Judy Bettencourt; Shelly L Sayre; Rachel W Vojvodic; Sonia I Skarlatos; David J Gordon; Ray F Ebert; Minjung Kwak; Lemuel A Moyé; Robert D Simari Journal: JAMA Date: 2011-11-14 Impact factor: 56.272
Authors: P Antonitsis; K Anastasiadis; G Koliakos; C Vaitsopoulou; K Kouzi-Koliakou; A Doumas; H Argiriadou; P Tossios Journal: Hippokratia Date: 2012-10 Impact factor: 0.471