Impact of intracoronary reinfusion of bone marrow-derived mononuclear progenitor cells on cardiopulmonary exercise capacity in patients with chronic postinfarction heart failure
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- 作者：Joerg Honold (1)
Ulrich Fischer-Rasokat (1)
Florian H. Seeger (1)
David Leistner (1)
Saskia Lotz (1)
Stefanie Dimmeler (2)
Andreas M. Zeiher (1)
Birgit Assmus (1) - 关键词：Ischaemic cardiomyopathy ; Bone marrow cells ; Heart failure ; Cardiopulmonary exercise capacity
- 刊名：Clinical Research in Cardiology
- 出版年：2013
- 出版时间：September 2013
- 年：2013
- 卷：102
- 期：9
- 页码：619-625
- 全文大小：255KB
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Ulrich Fischer-Rasokat (1)
Florian H. Seeger (1)
David Leistner (1)
Saskia Lotz (1)
Stefanie Dimmeler (2)
Andreas M. Zeiher (1)
Birgit Assmus (1)
1. Medizinische Klinik III/Kardiologie, Klinikum Goethe-Universit?t, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
2. Institute of Cardiovascular Regeneration, Center for Molecular Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
文摘
Introduction Intracoronary infusion of bone marrow-derived progenitor cells (BMC) in patients with chronic ischaemic heart failure (CHF) is associated with improvement in left ventricular ejection fraction (LVEF), reduction of NT-proBNP levels and improved prognosis. However, effects of this therapy on cardiopulmonary exercise capacity have not been investigated separately so far. Patients and methods One hundred and fifty-four patients with ischaemic heart failure (mean LVEF 40.3?±?10.9?%, NT-proBNP 1,103?±?1,436?pg/ml) underwent cardiopulmonary exercise capacity testing (CPX) before and 3?months after intracoronary infusion of autologous BMC. Thirty patients with a potential bias on the CPX course as concomitant coronary intervention, bypass surgery, new onset of arrhythmias or implantation of cardiac resynchronization devices were excluded from further analysis. Results The remaining 124 patients showed an increase in exercise time and peak workload by 16.8 and 6?%. Peak oxygen uptake and oxygen uptake efficiency slope also improved by 2.9 and 12.9?%, whereas other parameters like peak oxygen pulse and the slope of minute ventilation versus CO2 elimination remained unchanged. Analysis of patients with poor, moderate and conserved CPX results prior to cell therapy documented that patients in tertiles with lowest initial exercise capacity showed the largest improvements in CPX after therapy. The differences in response to cell therapy were detectable in all investigated CPX parameters and became significant for exercise time, peak oxygen uptake and peak oxygen pulse. Summary These findings indicate that intracoronary BMC therapy improves exercise capacity in CHF patients with more advanced heart failure.