Abstract 15127: The Effect of Intracoronary Infusion of Mobilized Peripheral Blood Stem Cells on Left Ventricular Function after Myocardial Infarction
Therapy with intracoronary infusion of stem cells after myocardial infarction is a safe procedure which may exert beneficial effects in patients with left ventricular dysfunction.
Purpose: We investigated the effect of autologous peripheral blood progenitor cells (PBPCs) administration on left ventricular function, in the subacute phase of large anterior myocardial infarction.
Methods: Study population consisted of 22 consecutive patients (mean age= 56.6±10.8 years) with anterior acute myocardial infarction (AMI) and left ventricular ejection fraction (LVEF) less than 45%, measured the 4th day post AMI. All patients were treated with percutaneous coronary angioplasty and stenting of the infarct related artery (IRA). Patients were randomized in two groups: In Group A (n=12), they received intracoronarily PBPCs, after mobilization by administration of G-CSF (filgrastim) for 5 days. Group B (n=10) was the control group and received optimal medical treatment. Left ventricular ejection fraction and dimensions were assessed at 6 months after cell administration, by echocardiography.
Results: In group A, CD34+ cells were isolated and collected with the procedure of leukopheresis. An average of 9.8±2.5x106 CD34+ cells was delivered by intracoronary infusion in the IRA at day 15±2 post AMI. After 5.6±1 months post infarction, in group A LVEF was 45±6.3% vs 39.2±3.5% at randomization (p=0.028), left ventricular end diastolic dimension (LVEDD) 57±5.9mm vs 51.3±4.6mm (p=0.019) and left ventricular end systolic dimension (LVESD) 39.6±7.2mm vs 34.8±4.6mm (p=0.048). In group B, LVEF was 35.2±8.2% after 6 months vs 37.9±6.1% at baseline (p=ns), LVEDD 59.5±10.5mm vs 50.9±6.4mm (p=0.005) and LVESD 43.5±10.7mm vs 36.1±7mm (p=0.014). At 6 months, LVEF was significantly higher in Group A in comparison with group B (45±6.3% vs 35.2±8.2%, p=0.005). During the follow up period, 2 patients of group A experienced angina recurrence, with positive treadmill test and a new significant stenosis in the IRA.
Conclusion: Patients who received therapy with PBPCs after a large anterior AMI that resulted in left ventricular dysfunction, demonstrated a significant improvement of LVEF on 6 months follow up, compared with patients who received the standard medical therapy.
- © 2011 by American Heart Association, Inc.