Effect of intracoronary bone marrow-derived mononuclear cell injection early and late after myocardial infarction on CMR-derived myocardial strain

M Gastl; D Sürder; R Corti; D M M Faruque Osmany; A Gotschy; J von Spizcak; J Sokolska; D Metzen; H Alkadhi; F Ruschitzka; S Kozerke; R Manka

doi:10.1016/j.ijcard.2020.01.025

Effect of intracoronary bone marrow-derived mononuclear cell injection early and late after myocardial infarction on CMR-derived myocardial strain

Int J Cardiol. 2020 Jul 1:310:108-115. doi: 10.1016/j.ijcard.2020.01.025. Epub 2020 Jan 15.

Authors

M Gastl¹, D Sürder², R Corti³, D M M Faruque Osmany⁴, A Gotschy⁵, J von Spizcak⁶, J Sokolska⁷, D Metzen⁸, H Alkadhi⁶, F Ruschitzka⁹, S Kozerke¹⁰, R Manka¹¹

Affiliations

¹ Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, Raemistrasse 100, 8091 Zurich, Switzerland; Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, 8092 Zurich, Switzerland.; Department Cardiology, Pneumology and Angiology, Heinrich Heine University, Düsseldorf, Germany.
² Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, Raemistrasse 100, 8091 Zurich, Switzerland; Department of Cardiology, Fondazione Cardiocentro Ticino, Lugano, Switzerland.
³ Cardiology Department, HerzKlinik Hirslanden, Zurich, Switzerland.
⁴ Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, Raemistrasse 100, 8091 Zurich, Switzerland; Department of Cardiology, University Cardiac Center, Bangabandhu Sheikh Mujib Medical University, 1000, Bangladesh.
⁵ Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, Raemistrasse 100, 8091 Zurich, Switzerland; Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, 8092 Zurich, Switzerland.
⁶ Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Raemistrasse 100, 8091 Zurich, Switzerland.
⁷ Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, Raemistrasse 100, 8091 Zurich, Switzerland; Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland.
⁸ Department Cardiology, Pneumology and Angiology, Heinrich Heine University, Düsseldorf, Germany.
⁹ Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, Raemistrasse 100, 8091 Zurich, Switzerland.
¹⁰ Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, 8092 Zurich, Switzerland.
¹¹ Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, Raemistrasse 100, 8091 Zurich, Switzerland; Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, 8092 Zurich, Switzerland.; Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Raemistrasse 100, 8091 Zurich, Switzerland. Electronic address: Robert.Manka@usz.ch.

PMID: 31982162
DOI: 10.1016/j.ijcard.2020.01.025

Abstract

Background: Studies indicate no clear impact of intracoronary injection of bone-marrow unselected mononuclear cells (BM-MNC) after acute myocardial infarction (AMI) on left-ventricular function (LVEF). Strain parameters by cardiovascular magnetic resonance (CMR) have been proposed to be more sensitive to functional changes of the heart. The aim of the present study was to assess changes of global longitudinal (GLS) and circumferential strain (GCS) in a group of patients treated with BM-MNC after AMI.

Methods: One-hundred and forty-nine patients with successfully reperfused AMI and LV dysfunction (LVEF<45%) were retrospectively included into this sub-study of the SWISS-AMI multicentre trial. Patients were divided into control (N = 54), early (5-7 days after AMI, N = 51) and late BM-MNC treatment groups (3-4 weeks, N = 44). The endpoint was the change of GLS and GCS as obtained from cine sequences 4 and 12 months after AMI using feature tracking algorithm.

Results: In unadjusted analyses, the absolute change of GLS for the early treatment group from baseline to 4 months was 2.5 ± 4.3 (p < 0.01), to 12 months 2.7 ± 5.7% (p = 0.004). For late treatment, it was 1.5 ± 4.0% (p = 0.039, 4 months) and 2.5 ± 5.6% (p = 0.015, 12 months). For controls 0.7 ± 4.7% (p = 0.378), 0.8 ± 3.9% (p = 0.253) respectively. Adjusting for different baseline values, neither an overall treatment effect (both time-points) of BM-MNC nor a treatment time-related (only early or late) effect could be shown for all functional parameters.

Conclusions: Among patients after AMI with successful reperfusion and LV dysfunction, intracoronary infusion of BM-MNC early or late after AMI did not improve global strain parameters at 4- or 12-months follow-up.

Clinical trial registration: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00355186.

Keywords: Acute myocardial infarction; CMR; Functional recovery; Intracoronary stem-cell injection; Myocardial strain.

Publication types

Clinical Trial
Multicenter Study

MeSH terms

Bone Marrow Transplantation
Bone Marrow*
Humans
Magnetic Resonance Spectroscopy
Myocardial Infarction* / diagnostic imaging
Myocardial Infarction* / therapy
Retrospective Studies
Treatment Outcome
Ventricular Function, Left

Associated data

ClinicalTrials.gov/NCT00355186