TY - JOUR
T1 - Improvement of exercise-induced cardiac deformation after cell therapy for severe chronic ischemic heart failure
AU - Lebrun, Frederic
AU - Berchem, Guy
AU - Delagardelle, Charles
AU - Beissel, Jean
AU - Rouy, Didier
AU - Wagner, Daniel R.
N1 - Funding Information:
Supported by grants from the Centre de Recherche Public Santé, Luxembourg and the Société pour la Recherche sur les Maladies Cardiovasculaires, Luxembourg.
PY - 2006/3
Y1 - 2006/3
N2 - Background: Intracoronary infusion of autologous bone marrow cells (CTX) has been shown to improve myocardial function in postinfarct patients and in patients with chronic ischemic cardiomyopathy. Whether CTX affects exercise-induced changes in cardiac deformation and mitral regurgitation (MR) in patients with end-stage heart failure has not been studied. Methods and Results: In this small pilot study, 11 patients with chronic ischemic cardiomyopathy, ejection fraction (EF) <25%, no inducible ischemia and heart failure class New York Heart Association (NYHA) III underwent CTX. Symptom-limited bicycle exercise echocardiography was performed pre- and 4 months post-CTX and maximum systolic strain (msyε), peak systolic strain rate (psysr), and effective regurgitant orifice of MR (ERO) were determined. There were no complications related to the procedure. The overall clinical benefit of CTX was limited with a trend towards improvement (NYHA 3.0 ± 0.1 pre- and 2.7 ± 0.2 post-CTX, P = .06). The EF did not improve after CTX. The wall motion score index did not change at rest but decreased significantly during exercise (1.48 ± 0.16 versus 1.44 ± 0.17, P = .01). In patients with non-viable areas, msyε, psysr, and ERO were not affected by CTX. However, in patients with viable areas, msyε and psysr appeared to increase during exercise and ERO appeared to decrease from 19 ± 5 to 16 ± 5 mm2. This effect was not apparent at rest and more pronounced with inferior viability. Conclusion: CTX may improve cardiac deformation and MR during exercise in patients with severe chronic heart failure when viable areas are targeted.
AB - Background: Intracoronary infusion of autologous bone marrow cells (CTX) has been shown to improve myocardial function in postinfarct patients and in patients with chronic ischemic cardiomyopathy. Whether CTX affects exercise-induced changes in cardiac deformation and mitral regurgitation (MR) in patients with end-stage heart failure has not been studied. Methods and Results: In this small pilot study, 11 patients with chronic ischemic cardiomyopathy, ejection fraction (EF) <25%, no inducible ischemia and heart failure class New York Heart Association (NYHA) III underwent CTX. Symptom-limited bicycle exercise echocardiography was performed pre- and 4 months post-CTX and maximum systolic strain (msyε), peak systolic strain rate (psysr), and effective regurgitant orifice of MR (ERO) were determined. There were no complications related to the procedure. The overall clinical benefit of CTX was limited with a trend towards improvement (NYHA 3.0 ± 0.1 pre- and 2.7 ± 0.2 post-CTX, P = .06). The EF did not improve after CTX. The wall motion score index did not change at rest but decreased significantly during exercise (1.48 ± 0.16 versus 1.44 ± 0.17, P = .01). In patients with non-viable areas, msyε, psysr, and ERO were not affected by CTX. However, in patients with viable areas, msyε and psysr appeared to increase during exercise and ERO appeared to decrease from 19 ± 5 to 16 ± 5 mm2. This effect was not apparent at rest and more pronounced with inferior viability. Conclusion: CTX may improve cardiac deformation and MR during exercise in patients with severe chronic heart failure when viable areas are targeted.
KW - Cell therapy
KW - Heart failure
KW - Stress echocardiography
UR - http://www.scopus.com/inward/record.url?scp=33644761739&partnerID=8YFLogxK
U2 - 10.1016/j.cardfail.2005.10.011
DO - 10.1016/j.cardfail.2005.10.011
M3 - Article
C2 - 16520257
AN - SCOPUS:33644761739
SN - 1071-9164
VL - 12
SP - 108
EP - 113
JO - Journal of Cardiac Failure
JF - Journal of Cardiac Failure
IS - 2
ER -