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Adenosine stress perfusion cardiac magnetic resonance imaging in patients undergoing intracoronary bone marrow cell transfer after ST-elevation myocardial infarction: the BOOST-2 perfusion substudy.
Seitz, Andreas; Wollert, Kai C; Meyer, Gerd P; Müller-Ehmsen, Jochen; Tschöpe, Carsten; May, Andreas E; Empen, Klaus; Chorianopoulos, Emmanuel; Ritter, Benedikta; Pirr, Jens; Arseniev, Lubomir; Heuft, Hans-Gert; Ganser, Arnold; Abu-Zaid, Eed; Katus, Hugo A; Felix, Stephan B; Gawaz, Meinrad P; Schultheiss, Heinz-Peter; Ladage, Dennis; Bauersachs, Johann; Mahrholdt, Heiko; Greulich, Simon.
Afiliação
  • Seitz A; Department of Cardiology, Robert-Bosch-Medical Centre, Stuttgart, Germany.
  • Wollert KC; Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany.
  • Meyer GP; Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany.
  • Müller-Ehmsen J; Department of Cardiology, University Heart Centre Cologne, Cologne, Germany.
  • Tschöpe C; Department of Cardiology, Charité University Hospital, Berlin, Germany.
  • May AE; Department of Cardiology and Cardiovascular Diseases, University of Tübingen, Otfried-Müller-Straße 10, 72076, Tübingen, Germany.
  • Empen K; Department of Cardiology, University Medicine Greifswald, Greifswald, Germany.
  • Chorianopoulos E; Department of Cardiology, Angiology, and Pneumology, University of Heidelberg, Heidelberg, Germany.
  • Ritter B; Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany.
  • Pirr J; Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany.
  • Arseniev L; Cellular Therapy Centre, Hannover Medical School, Hannover, Germany.
  • Heuft HG; Institute for Transfusion Medicine, Hannover Medical School, Hannover, Germany.
  • Ganser A; Department of Haematology, Haemostasis, Oncology, and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany.
  • Abu-Zaid E; Department of Cardiology, Robert-Bosch-Medical Centre, Stuttgart, Germany.
  • Katus HA; Department of Cardiology, Angiology, and Pneumology, University of Heidelberg, Heidelberg, Germany.
  • Felix SB; Department of Cardiology, University Medicine Greifswald, Greifswald, Germany.
  • Gawaz MP; Department of Cardiology and Cardiovascular Diseases, University of Tübingen, Otfried-Müller-Straße 10, 72076, Tübingen, Germany.
  • Schultheiss HP; Department of Cardiology, Charité University Hospital, Berlin, Germany.
  • Ladage D; Department of Cardiology, University Heart Centre Cologne, Cologne, Germany.
  • Bauersachs J; Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany.
  • Mahrholdt H; Department of Cardiology, Robert-Bosch-Medical Centre, Stuttgart, Germany.
  • Greulich S; Department of Cardiology, Robert-Bosch-Medical Centre, Stuttgart, Germany. simon.greulich@med.uni-tuebingen.de.
Clin Res Cardiol ; 109(5): 539-548, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31401672
ABSTRACT

AIMS:

In the placebo-controlled, double-blind BOne marrOw transfer to enhance ST-elevation infarct regeneration (BOOST) 2 trial, intracoronary autologous bone marrow cell (BMC) transfer did not improve recovery of left ventricular ejection fraction (LVEF) at 6 months in patients with ST-elevation myocardial infarction (STEMI) and moderately reduced LVEF. Regional myocardial perfusion as determined by adenosine stress perfusion cardiac magnetic resonance imaging (S-CMR) may be more sensitive than global LVEF in detecting BMC treatment effects. Here, we sought to evaluate (i) the changes of myocardial perfusion in the infarct area over time (ii) the effects of BMC therapy on infarct perfusion, and (iii) the relation of infarct perfusion to LVEF recovery at 6 months. METHODS AND

RESULTS:

In 51 patients from BOOST-2 (placebo, n = 10; BMC, n = 41), S-CMR was performed 5.1 ± 2.9 days after PCI (before placebo/BMC treatment) and after 6 months. Infarct perfusion improved from baseline to 6 months in the overall patient cohort as reflected by the semi-quantitative parameters, perfusion defect-infarct size ratio (change from 0.54 ± 0.20 to 0.43 ± 0.22; P = 0.006) and perfusion defect-upslope ratio (0.54 ± 0.23 to 0.68 ± 0.22; P < 0.001), irrespective of randomised treatment. Perfusion defect-upslope ratio at baseline correlated with LVEF recovery (r = 0.62; P < 0.001) after 6 months, with a threshold of 0.54 providing the best sensitivity (79%) and specificity (74%) (area under the curve, 0.79; 95% confidence interval, 0.67-0.92).

CONCLUSION:

Infarct perfusion improves from baseline to 6 months and predicts LVEF recovery in STEMI patients undergoing early PCI. Intracoronary BMC therapy did not enhance infarct perfusion in the BOOST-2 trial.
Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Tipo de estudo: Ensaio clínico controlado Idioma: Inglês Revista: Clin Res Cardiol Assunto da revista: Cardiologia Ano de publicação: 2020 Tipo de documento: Artigo País de afiliação: Alemanha

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Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Tipo de estudo: Ensaio clínico controlado Idioma: Inglês Revista: Clin Res Cardiol Assunto da revista: Cardiologia Ano de publicação: 2020 Tipo de documento: Artigo País de afiliação: Alemanha