Document Detail

Early increase in myocardial perfusion after stem cell therapy in patients undergoing incomplete coronary artery bypass surgery.
MedLine Citation:
PMID:  21061106     Owner:  NLM     Status:  In-Process    
Incomplete revascularization is associated with worse long-term outcomes. Autologous bone marrow cells (BMC) have recently been tested in patients with severe coronary artery disease. We tested the hypothesis that intramyocardial injection of autologous BMC increases myocardial perfusion in patients undergoing incomplete coronary artery bypass grafting (CABG). Twenty-one patients (19 men), 59 ± 7 years old, with limiting angina and multivessel coronary artery disease (CAD), not amenable to complete CABG were enrolled. BMC were obtained prior to surgery, and the lymphomonocytic fraction separated by density gradient centrifugation. During surgery, 5 mL containing 2.1 ± 1.3 × 108 BMC (CD34+ = 0.8 ± 0.3%) were injected in the ischemic non-revascularized myocardium. Myocardial perfusion was assessed by magnetic resonance imaging (MRI) at baseline and 1 month after surgery. The increase in myocardial perfusion was compared between patients with <50% (group A, n = 11) with that of patients with >50% (group B, n = 10) of target vessels (stenosis ≥ 70%) successfully bypassed. Injected myocardial segments included the inferior (n = 12), anterior (n = 7), and lateral (n = 2) walls. The number of treated vessels (2.3 ± 0.8) was significantly smaller than the number of target vessels (4.2 ± 1.0; P < 0.0001). One month after surgery, cardiac MRI showed a similar reduction (%) in the ischemic score of patients in group A (72.5 ± 3.2), compared to patients in group B (78.1 ± 3.2; P = .80). Intramyocardial injection of autologous BMC may help increase myocardial perfusion in patients undergoing incomplete CABG, even in those with fewer target vessels successfully treated. This strategy may be an adjunctive therapy for patients suffering from a more advanced (diffuse) CAD not amenable for complete direct revascularization.
Luís Henrique Wolff Gowdak; Isolmar Tadeu Schettert; Carlos Eduardo Rochitte; Luiz Augusto Ferreira Lisboa; Luís Alberto Oliveira Dallan; Luiz Antônio Machado César; Sérgio Almeida de Oliveira; José Eduardo Krieger
Related Documents :
17449936 - Clinical outcome of urgent coronary artery bypass grafting.
6605676 - Relation between qrs changes and left ventricular function after coronary artery bypass...
24828526 - Management of acute right ventricular failure in the intensive care unit.
14643816 - Novel pharmacological preconditioning with diazoxide attenuates myocardial stunning in ...
14557696 - Dobutamine stress echocardiography in hypertrophic cardiomyopathy.
6736846 - Pseudo failure of sensing in patients with universal pacemakers and junctional rhythms.
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of cardiovascular translational research     Volume:  4     ISSN:  1937-5395     ISO Abbreviation:  J Cardiovasc Transl Res     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-01-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101468585     Medline TA:  J Cardiovasc Transl Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  106-13     Citation Subset:  IM    
Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of São Paulo Medical School, Av. Dr. Enéas de Carvalho Aguiar, 44, 05403-000 São Paulo, SP, Brazil.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Stem cells and their derivatives: a renaissance in cardiovascular translational research.
Next Document:  Perioperative intravenous lidocaine infusion for postoperative pain control: a meta-analysis of rand...