Myocardial blood flow and infarct size after CD133+ cell injection in large myocardial infarction with good recanalization and poor reperfusion: Results from a randomized controlled trial

Alessandro Colombo, Massimo Castellani, Emanuela Piccaluga, Enrico Pusineri, Simone Palatresi, Virgilio Longari, Cristina Canzi, Elisabetta Sacchi, Edoardo Rossi, Roberto Rech, Paolo Gerundini, Maurizio Viecca, Giorgio Lambertenghi Deliliers, Paolo Rebulla, Davide Soligo, Rosaria Giordano

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Abstract

OBJECTIVE: Large acute ST-elevation myocardial infarction (STEMI) sometimes leaves extensive ischemic damage despite timely and successful primary angioplasty. This clinical picture of good recanalization with incomplete reperfusion represents a good model to assess the reparative potential of locally administered cell therapy. Thus, we conducted a randomized controlled trial aimed at evaluating the effect of intracoronary administration of CD133 stem cells on myocardial blood flow and function in this setting. METHODS: Fifteen patients with large anterior STEMI, myocardial blush grade 0-1 and more than 50% ST-elevation recovery after optimal coronary recanalization (TIMI 3 flow) with stenting were randomly assigned to receive CD133 cells from either bone marrow (group A) or peripheral blood (group B), or to stay on drug therapy alone (group C). The cells were intracoronary injected within 10-14 days of STEMI. Infarct-related myocardial blood flow (MBF) was evaluated by NH positron emission tomography 2-5 days before cell administration and after 1 year. RESULTS: MBF increased in the infarct area from 0.419 (0.390-0.623) to 0.544 (0.371-0.729) ml/min per g in group A, decreased from 0.547 (0.505-0.683) to 0.295 (0.237-0.472) ml/min per g in group B and only slightly changed from 0.554 (0.413-0.662) to 0.491 (0.453-0.717) ml/min per g in group C (A vs. C: P = 0.023; B vs. C: P = 0.066). Left ventricular volume tended to increase more in groups B and C than in group A, ejection fraction and wall motion score index remained stable in the three groups. CONCLUSION: These findings support the hypothesis that intracoronary administration of bone marrow-derived, but not peripheral blood-derived CD133 cells 10-14 days after STEMI may improve long-term perfusion.

Original languageEnglish
Pages (from-to)239-248
Number of pages10
JournalJournal of Cardiovascular Medicine
Volume12
Issue number4
DOIs
Publication statusPublished - Apr 2011

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Reperfusion
Randomized Controlled Trials
Myocardial Infarction
Injections
Cell- and Tissue-Based Therapy
Angioplasty
Bone Marrow Cells
Positron-Emission Tomography
Stem Cells
Perfusion
Bone Marrow
Drug Therapy
ST Elevation Myocardial Infarction

Keywords

  • myocardial infarction
  • PET
  • stem cells

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Myocardial blood flow and infarct size after CD133+ cell injection in large myocardial infarction with good recanalization and poor reperfusion : Results from a randomized controlled trial. / Colombo, Alessandro; Castellani, Massimo; Piccaluga, Emanuela; Pusineri, Enrico; Palatresi, Simone; Longari, Virgilio; Canzi, Cristina; Sacchi, Elisabetta; Rossi, Edoardo; Rech, Roberto; Gerundini, Paolo; Viecca, Maurizio; Deliliers, Giorgio Lambertenghi; Rebulla, Paolo; Soligo, Davide; Giordano, Rosaria.

In: Journal of Cardiovascular Medicine, Vol. 12, No. 4, 04.2011, p. 239-248.

Research output: Contribution to journalArticle

Colombo, Alessandro ; Castellani, Massimo ; Piccaluga, Emanuela ; Pusineri, Enrico ; Palatresi, Simone ; Longari, Virgilio ; Canzi, Cristina ; Sacchi, Elisabetta ; Rossi, Edoardo ; Rech, Roberto ; Gerundini, Paolo ; Viecca, Maurizio ; Deliliers, Giorgio Lambertenghi ; Rebulla, Paolo ; Soligo, Davide ; Giordano, Rosaria. / Myocardial blood flow and infarct size after CD133+ cell injection in large myocardial infarction with good recanalization and poor reperfusion : Results from a randomized controlled trial. In: Journal of Cardiovascular Medicine. 2011 ; Vol. 12, No. 4. pp. 239-248.
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abstract = "OBJECTIVE: Large acute ST-elevation myocardial infarction (STEMI) sometimes leaves extensive ischemic damage despite timely and successful primary angioplasty. This clinical picture of good recanalization with incomplete reperfusion represents a good model to assess the reparative potential of locally administered cell therapy. Thus, we conducted a randomized controlled trial aimed at evaluating the effect of intracoronary administration of CD133 stem cells on myocardial blood flow and function in this setting. METHODS: Fifteen patients with large anterior STEMI, myocardial blush grade 0-1 and more than 50{\%} ST-elevation recovery after optimal coronary recanalization (TIMI 3 flow) with stenting were randomly assigned to receive CD133 cells from either bone marrow (group A) or peripheral blood (group B), or to stay on drug therapy alone (group C). The cells were intracoronary injected within 10-14 days of STEMI. Infarct-related myocardial blood flow (MBF) was evaluated by NH positron emission tomography 2-5 days before cell administration and after 1 year. RESULTS: MBF increased in the infarct area from 0.419 (0.390-0.623) to 0.544 (0.371-0.729) ml/min per g in group A, decreased from 0.547 (0.505-0.683) to 0.295 (0.237-0.472) ml/min per g in group B and only slightly changed from 0.554 (0.413-0.662) to 0.491 (0.453-0.717) ml/min per g in group C (A vs. C: P = 0.023; B vs. C: P = 0.066). Left ventricular volume tended to increase more in groups B and C than in group A, ejection fraction and wall motion score index remained stable in the three groups. CONCLUSION: These findings support the hypothesis that intracoronary administration of bone marrow-derived, but not peripheral blood-derived CD133 cells 10-14 days after STEMI may improve long-term perfusion.",
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T1 - Myocardial blood flow and infarct size after CD133+ cell injection in large myocardial infarction with good recanalization and poor reperfusion

T2 - Results from a randomized controlled trial

AU - Colombo, Alessandro

AU - Castellani, Massimo

AU - Piccaluga, Emanuela

AU - Pusineri, Enrico

AU - Palatresi, Simone

AU - Longari, Virgilio

AU - Canzi, Cristina

AU - Sacchi, Elisabetta

AU - Rossi, Edoardo

AU - Rech, Roberto

AU - Gerundini, Paolo

AU - Viecca, Maurizio

AU - Deliliers, Giorgio Lambertenghi

AU - Rebulla, Paolo

AU - Soligo, Davide

AU - Giordano, Rosaria

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N2 - OBJECTIVE: Large acute ST-elevation myocardial infarction (STEMI) sometimes leaves extensive ischemic damage despite timely and successful primary angioplasty. This clinical picture of good recanalization with incomplete reperfusion represents a good model to assess the reparative potential of locally administered cell therapy. Thus, we conducted a randomized controlled trial aimed at evaluating the effect of intracoronary administration of CD133 stem cells on myocardial blood flow and function in this setting. METHODS: Fifteen patients with large anterior STEMI, myocardial blush grade 0-1 and more than 50% ST-elevation recovery after optimal coronary recanalization (TIMI 3 flow) with stenting were randomly assigned to receive CD133 cells from either bone marrow (group A) or peripheral blood (group B), or to stay on drug therapy alone (group C). The cells were intracoronary injected within 10-14 days of STEMI. Infarct-related myocardial blood flow (MBF) was evaluated by NH positron emission tomography 2-5 days before cell administration and after 1 year. RESULTS: MBF increased in the infarct area from 0.419 (0.390-0.623) to 0.544 (0.371-0.729) ml/min per g in group A, decreased from 0.547 (0.505-0.683) to 0.295 (0.237-0.472) ml/min per g in group B and only slightly changed from 0.554 (0.413-0.662) to 0.491 (0.453-0.717) ml/min per g in group C (A vs. C: P = 0.023; B vs. C: P = 0.066). Left ventricular volume tended to increase more in groups B and C than in group A, ejection fraction and wall motion score index remained stable in the three groups. CONCLUSION: These findings support the hypothesis that intracoronary administration of bone marrow-derived, but not peripheral blood-derived CD133 cells 10-14 days after STEMI may improve long-term perfusion.

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