P6398Peculiarities of the dynamics of fibrosis markers at the in-hospital stage in myocardial infarction patients with preserved left ventricular ejection fraction

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A V Osokina ◽  
V N Karetnikova ◽  
O M Polikutina ◽  
Y U S Slepynina ◽  
O V Gruzdeva ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Myocardial Contractility ◽  
Myocardial Dysfunction ◽  
Ventricular Myocardium ◽  
Serum Markers ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Left Ventricular Myocardium ◽  
Ventricular Ejection Fraction

Abstract Purpose To identify the peculiarities of the dynamics of fibrosis markers in patients with STEMI and preserved myocardial contractility and to determine the relationship between the studied biomarkers and EchoCG indicators characterizing the violation of left ventricular myocardium diastolic function. Material and methods The study included 120 patients with STEMI. The final analysis included 83 patients with preserved left ventricular myocardial contractility measured. The preserved ejection fraction was considered to be ≥50%. Echocardiographic examination was performed using Sonos 2500. In addition to the standard laboratory and instrumental examinations, all the patients underwent the estimation of the concentrations of PICP and PIIINP by enzyme-linked immunoassay using BCM Diagnostics laboratory kits (USA) on the 1st and the 12th days of disease. To compare the obtained values of the studied markers, a control group of healthy volunteers matched by age and gender with the main sample of the patients, was recruited, n=20 (100%). In this group the following values were obtained: PIIINP 7.2 [6.8; 7.5] ng/ml, PICP 179.2 [163.5; 194.9] ng/ml. Statistical processing of the obtained data was performed using Statistica 6.0 software. Results The mean age of the patients was 58.8 years; LVEF was 59.0% [54; 62]. According to EchoCG data, LV dysfunction at normal dimensions was registered in 59 (72%) patients, dilatation – in 22 (27%) patients and regional contractility violation – in 43 (52.4%) cases. The increased values of Tei index 0.70 [0.63; 0.76] and myocardial mass 241.0 g [206.5; 272.0] stand out. The values of serum markers concentrations obtained on the 1st day of STEMI, significantly exceeded the values of the control group and were as follows: PIIINP 26.0 (18.9; 34.9) ng/ml (p=0.047), PICP – 609.0 (583.0; 635.0) ng/ml (p=0.049). On the 12th day the concentration of PICP - 588.0 (580.0; 621.0) ng/ml, PIIINP – 24.2 (18.6; 30.3) ng/ml. No statistically significant differences were obtained in comparison of the markers' concentrations on the 1st and 12th days of the disease. As a result of the correlation analysis between the values of the studied serum markers and EchoCG indicators the following statistically significant relationships were identified: E/Em the 1st day - PICP the 12th day: r=0.55, p=0.005; E/A the 12th day - PICP the 1st day: r=−0.42, p=0.033; E/Em the 12th day - PICP the 12th day: r=0.48, p=0.015; EDV the 12th day - PIIINP the 1st day: r=0.62, p=0.001; EDI the 12th day - PIIINP the 1st day: r=0.43, p=0.034; Age - PIIINP the 1st day: r=0.558, p=0.016. Conclusion The presence of statistically significant correlations between the concentrations of PIIINP, PICP with EchoCG indicators evidence the role of fibrosis in the formation of diastolic myocardial dysfunction and reflect the potential use of procollagen to predict heart failure in long-term post-infarction period.

scholarly journals Ultrasound Study of Layer-specific Strain and Perfusion of Left Ventricular Myocardium in Patients With Dilated Cardiomyopathy

2021 ◽  
Author(s):  
Sha Tang ◽  
Lina Guan ◽  
Yuming Mu
Keyword(s):  
Dilated Cardiomyopathy ◽  
Correlation Coefficients ◽  
Ventricular Myocardium ◽  
Left Ventricular ◽  
Volume Index ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Left Ventricular Myocardium ◽  
Ventricular Ejection Fraction ◽  
Myocardial Microcirculation

Abstract BackgroundTo investigate the changes in deformation and myocardial microcirculation perfusion of left ventricular three-layer myocardium in patients with dilated cardiomyopathy (DCM) by using speckle tracking imaging (STI) and myocardial contrast echocardiography (MCE).MethodsTwenty-four patients with DCM and 19 healthy controls were selected. Two-dimensional and MCE dynamic images of apical four-chamber, two-chamber, and three-chamber sections and left ventricular mitral valve, papillary muscle and apex sections were collected. The peak values of longitudinal strain (LS), circumferential strain (CS), cross-sectional area of a microvessel (A) and average myocardial microvascular lesion (β) were obtained by Qlab 10.8 workstation values, and myocardial blood flow (MBF) was calculated with A×β to evaluate the deformation and coronary microvascular perfusion of left ventricular three-layer myocardium.ResultsThe brain natriuretic peptide (BNP), left ventricular mass index (LVMI), left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVEDS), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left atrial volume index (LAVI), E peak in early diastolic period/A peak velocity in late diastolic period (E/A) and average E/e' in the DCM group were higher than those in the control group (P < 0.05); left ventricular ejection fraction (LVEF), left ventricular fractional shortening (FS) rate, stroke volume (SV), cardiac output (CO), cardiac index (CI), A peak, and the e' and a' velocities of both the lateral wall and interventricular septum were smaller than those in the control group (P<0.05). The LS, CS, A, β, and A×β of the DCM group were all lower than those of the control group (P < 0.05). The pattern of myocardial strain and perfusion among myocardial layers was subendocardial>middle>subepicardial. The correlation coefficients of LS with A, β, and A×β were -0.500, -0.279 and -0.190, respectively, and the correlation coefficients of CS with A, β, and A×β were -0.383, -0.255 and -0.208, respectively.ConclusionsThe deformation of the three-layer myocardium and coronary microcirculation perfusion in DCM patients were diffusely damaged from the endocardium to the epicardium, layer by layer. The longitudinal function of the left ventricular myocardium was closely related to changes in myocardial microcirculation perfusion.

scholarly journals Ultrasound Study of Layer-specific Strain and Perfusion of Left Ventricular Myocardium in Patients With Dilated Cardiomyopathy

2021 ◽  
Author(s):  
Sha Tang ◽  
Lina Guan ◽  
Yuming Mu
Keyword(s):  
Dilated Cardiomyopathy ◽  
Correlation Coefficients ◽  
Ventricular Myocardium ◽  
Left Ventricular ◽  
Volume Index ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Left Ventricular Myocardium ◽  
Ventricular Ejection Fraction ◽  
Myocardial Microcirculation

Abstract BackgroundTo investigate the changes in deformation and myocardial microcirculation perfusion of left ventricular three-layer myocardium in patients with dilated cardiomyopathy (DCM) by using speckle tracking imaging (STI) and myocardial contrast echocardiography (MCE).MethodsTwenty-four patients with DCM and 19 healthy controls were selected. Two-dimensional and MCE dynamic images of apical four-chamber, two-chamber, and three-chamber sections and left ventricular mitral valve, papillary muscle and apex sections were collected. The peak values of longitudinal strain (LS), circumferential strain (CS), cross-sectional area of a microvessel (A) and average myocardial microvascular lesion (β) were obtained by Qlab 10.8 workstation values, and myocardial blood flow (MBF) was calculated with A×β to evaluate the deformation and coronary microvascular perfusion of left ventricular three-layer myocardium.ResultsThe brain natriuretic peptide (BNP), left ventricular mass index (LVMI), left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVEDS), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left atrial volume index (LAVI), E peak in early diastolic period/A peak velocity in late diastolic period (E/A) and average E/e' in the DCM group were higher than those in the control group (P < 0.05); left ventricular ejection fraction (LVEF), left ventricular fractional shortening (FS) rate, stroke volume (SV), cardiac output (CO), cardiac index (CI), A peak, and the e' and a' velocities of both the lateral wall and interventricular septum were smaller than those in the control group (P<0.05). The LS, CS, A, β, and A×β of the DCM group were all lower than those of the control group (P < 0.05). The pattern of myocardial strain and perfusion among myocardial layers was subendocardial>middle>subepicardial. The correlation coefficients of LS with A, β, and A×β were -0.500, -0.279 and -0.190, respectively, and the correlation coefficients of CS with A, β, and A×β were -0.383, -0.255 and -0.208, respectively.ConclusionsThe deformation of the three-layer myocardium and coronary microcirculation perfusion in DCM patients were diffusely damaged from the endocardium to the epicardium, layer by layer. The longitudinal function of the left ventricular myocardium was closely related to changes in myocardial microcirculation perfusion.

scholarly journals Ultrasound Study of Layer-specific Strain and Perfusion of Left Ventricular Myocardium in Patients With Dilated Cardiomyopathy

2021 ◽  
Author(s):  
Sha Tang ◽  
Lina Guan ◽  
Yuming Mu
Keyword(s):  
Dilated Cardiomyopathy ◽  
Correlation Coefficients ◽  
Ventricular Myocardium ◽  
Left Ventricular ◽  
Volume Index ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Left Ventricular Myocardium ◽  
Ventricular Ejection Fraction ◽  
Myocardial Microcirculation

Abstract BackgroundTo investigate the changes in deformation and myocardial microcirculation perfusion of left ventricular three-layer myocardium in patients with dilated cardiomyopathy (DCM) by using speckle tracking imaging (STI) and myocardial contrast echocardiography (MCE).MethodsTwenty-four patients with DCM and 19 healthy controls were selected. Two-dimensional and MCE dynamic images of apical four-chamber, two-chamber, and three-chamber sections and left ventricular mitral valve, papillary muscle and apex sections were collected. The peak values of longitudinal strain (LS), circumferential strain (CS), cross-sectional area of a microvessel (A) and average myocardial microvascular lesion (β) were obtained by Qlab 10.8 workstation values, and myocardial blood flow (MBF) was calculated with A×β to evaluate the deformation and coronary microvascular perfusion of left ventricular three-layer myocardium.ResultsThe brain natriuretic peptide (BNP), left ventricular mass index (LVMI), left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVEDS), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left atrial volume index (LAVI), E peak in early diastolic period/A peak velocity in late diastolic period (E/A) and average E/e' in the DCM group were higher than those in the control group (P < 0.05); left ventricular ejection fraction (LVEF), left ventricular fractional shortening (FS) rate, stroke volume (SV), cardiac output (CO), cardiac index (CI), A peak, and the e' and a' velocities of both the lateral wall and interventricular septum were smaller than those in the control group (P<0.05). The LS, CS, A, β, and A×β of the DCM group were all lower than those of the control group (P < 0.05). The pattern of myocardial strain and perfusion among myocardial layers was subendocardial>middle>subepicardial. The correlation coefficients of LS with A, β, and A×β were -0.500, -0.279 and -0.190, respectively, and the correlation coefficients of CS with A, β, and A×β were -0.383, -0.255 and -0.208, respectively.ConclusionsThe deformation of the three-layer myocardium and coronary microcirculation perfusion in DCM patients were diffusely damaged from the endocardium to the epicardium, layer by layer. The longitudinal function of the left ventricular myocardium was closely related to changes in myocardial microcirculation perfusion.

Electrophysiologic properties and ventricular fibrillation in normal and myopathic hearts

1999 ◽  
Vol 77 (7) ◽  
pp. 510-519 ◽  
Author(s):  
Katherine M Kavanagh ◽  
Patricia A Guerrero ◽  
Bodh I Jugdutt ◽  
Francis X Witkowski ◽  
Jeffrey E Saffitz
Keyword(s):  
Ventricular Fibrillation ◽  
Myocardial Dysfunction ◽  
Myocardial Cell ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Functional Abnormality ◽  
Ventricular Ejection Fraction ◽  
Anisotropic Properties

This study tests the hypothesis that moderate myocardial dysfunction is associated with altered myocardial anisotropic properties and structurally altered ventricular fibrillation (VF). Mongrel dogs were randomized to either a control group or a group that was rapidly paced at 250 beats/min until the left ventricular ejection fraction was [Formula: see text] 40%. Changes in anisotropic properties and the electrical characteristics of VF associated with the development of moderate myocardial dysfunction were assessed by microminiature epicardial mapping studies. In vivo conduction, refractory periods, and repolarization times were prolonged in both longitudinal and transverse directions in myopathic animals versus controls. VF was different in myopathic versus control animals. There were significantly more conducted deflections during VF in normal hearts compared with myopathic hearts. Propagated deflection-to-deflection intervals during VF were significantly longer in myopathic hearts compared with controls (125.5 ± 49.06 versus 103.4 ± 32.9 ms, p = 0.009). There were no abnormalities in cell size, cell shape, or the number of intercellular gap junctions and there was no detectable change in the expression of the gap junction proteins Cx43 and Cx45. Moderate myocardial dysfunction is associated with significant electrophysiological abnormalities in the absence of changes in myocardial cell morphology or intercellular connections, suggesting a functional abnormality in cell-to-cell communication.Key words: cardiomyopathy, anisotropy, fibrillation, defibrillation.

scholarly journals P971 The echocardiographic phenotype in patients with cardiac amyloidosis and heart failure with preserved ejection fraction

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
M D M Perez Gil ◽  
V Mora Llabata ◽  
A Saad ◽  
A Sorribes Alonso ◽  
V Faga ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Cardiac Amyloidosis ◽  
Nyha Class ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Ventricular Ejection Fraction ◽  
Apical Rotation ◽  
Dynamic Torsion

Abstract BACKGROUND New echocardiographic phenotypes of heart failure (HF) are focused on myocardial systolic involvement of the left ventricle (LV), either endocardial and/or transmural. PURPOSE. To study the pattern of myocardial involvement in patients (p) with HF with preserved left ventricular ejection fraction (pLVEF) and cardiac amyloidosis (CA). METHODS. Comparative study of 16 p with CA and HF with pLVEF, considering as cut point LVEF &gt; 50%, in NYHA class ≥ II / IV, and a control group of 16 healthy people. Longitudinal Strain (LS) and Circumferential Strain (CS) were calculated using 2D speckle-tracking echocardiography, along with Mitral Annulus Plane Systolic Excursion (MAPSE) and Base-Apex distance (B-A). Also, the following indexes were calculated: Twist (apical rotation + basal rotation, º); Classic Torsion (TorC): (twist/B-A, º/cm); Torsion Index (Tor.I): (twist/MAPSE, º/cm) and Deformation Index (Def.I): (twist/LS, º). We suggest the introduction of these dynamic torsion indexes as Tor.I and Def.I that include twist per unit of longitudinal systolic shortening of the LV instead of using TorC which is the normalisation of twist to the end-diastolic longitudinal diameter of the LV. RESULTS There were no differences of age between the groups (68.2 ± 11.5 vs 63.7 ± 2.8 years, p = 0.14). Global values of LS and CS were lower in p with CA indicating endocardial and transmural deterioration during systole, while TorC and Twist of the LV remained conserved in p with CA. However, there is an increase of dynamic torsion parameters such as Tor.I and Def.I that show an increased Twist per unit of longitudinal shortening of the LV in the CA group (Table). CONCLUSIONS In p with CA and HF with pLVEF, the impairment of LS and CS indicates endocardial and transmural systolic dysfunction. In these conditions, LVEF would be preserved at the expense of a greater dynamic torsion of the LV. Table LS (%) CS (%) Twist (º) TorC (º/cm) Tor.I (º/cm) Def.I (º/%) CA pLVEF (n = 16) -11.7 ± 4.2 17.2 ± 4.8 19.8 ± 8.3 2.5 ± 1.1 27.7 ± 13.5 -1.8 ± 0.9 Control Group (n = 15) -20.6 ± 2.5 22.7 ± 4.9 21.7 ± 6.1 2.7 ± 0.8 16.4 ± 4.7 -1.0 ± 0.3 p &lt; 0.001 &lt; 0.01 0.46 0.46 &lt; 0.01 &lt; 0.01 Dynamic Torsion Indexes and Classic Torion Parameters in pLVEF CA patients vs Control group.

scholarly journals Intra-Arrest Administration of Cyclosporine and Methylprednisolone Does Not Reduce Postarrest Myocardial Dysfunction

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Meshe Chonde ◽  
Katharyn L. Flickinger ◽  
Matthew L. Sundermann ◽  
Allison C. Koller ◽  
David D. Salcido ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Myocardial Dysfunction ◽  
Spontaneous Circulation ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Left Ventricular Ejection ◽  
Sampled Data ◽  
Ventricular Ejection Fraction

Objective. To determine whether the administration of intra-arrest cyclosporine (CCY) and methylprednisolone (MP) preserves left ventricular ejection fraction (LVEF) and cardiac output (CO) after return of spontaneous circulation (ROSC). Methods. Eleven, 25-30kg female swine were randomized to receive 10mg/kg CCY + 40mg MP or placebo, anesthetized and given a transthoracic shock to induce ventricular fibrillation. After 8 minutes, standard CPR was started. After two additional minutes, the experimental agent was administered. Animals with ROSC were supported for up to 12h with norepinephrine as needed. Echocardiography was performed at baseline, and 1, 2, 6 and 12h post-ROSC. Analysis was performed using generalized estimating equations (GEE) after downsampling continuously sampled data to 5 minute epochs. Results. Eight animals (64%) achieved ROSC after a median of 7 [IQR 5-13] min of CPR, 2 [ IQR 1-3] doses of epinephrine and 2 [IQR 1-5] defibrillation shocks. Animals receiving CCY+MP had higher post ROSC MAP (GEE coefficient -10.2, P = <0.01), but reduced cardiac output (GEE coefficient 0.8, P = <0.01) compared to placebo. There was no difference in LVEF or vasopressor use between arms. Conclusions. Intra-arrest cyclosporine and methylprednisolone decreased post-arrest cardiac output and increased mean arterial pressure without affecting left ventricular ejection fraction.

scholarly journals P818 Association between baseline left ventricular longitudinal strain and follow-up left ventricular ejection fraction in patients with dilated cardiomyopathy

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
I H Jung ◽  
Y S Byun ◽  
J H Park
Keyword(s):  
Ejection Fraction ◽  
Longitudinal Strain ◽  
Myocardial Dysfunction ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Reverse Remodeling ◽  
Lv Function ◽  
Ventricular Ejection Fraction

Abstract Funding Acknowledgements no Background Left ventricular global longitudinal strain (LV GLS) offers sensitive and reproducible measurement of myocardial dysfunction. The authors sought to evaluate whether LV GLS at the time of diagnosis may predict LV reverse remodeling (LVRR) in DCM patients with sinus rhythm and also investigate the relationship between baseline LV GLS and follow-up LVEF. Methods We enrolled patients with DCM who had been initially diagnosed, evaluated, and followed at our institute. Results During the mean follow-up duration of 37.3 ± 21.7 months, LVRR occurred in 28% of patients (n = 45) within 14.7 ± 10.0 months of medical therapy. The initial LV ejection fraction (LVEF) of patients who recovered LV function was 26.1 ± 7.9% and was not different from the value of 27.1 ± 7.4% (p = 0.49) of those who did not recover. There was a moderate and highly significant correlation between baseline LV GLS and follow-up LVEF (r = 0.717; p &lt;0.001). Conclusion There was a significant correlation between baseline LV GLS and follow-up LVEF in this population. Baseline Follow-up Difference (95% CI) p-value All patients (n = 160) LVEDDI, mm/m2 35.6 ± 6.6 35.6 ± 6.6 -2.7 (-3.4 to -2.0) &lt;0.001 LVESDI, mm/m2 30.3 ± 6.1 26.6 ± 6.6 -3.7 (-4.6 to -2.8) &lt;0.001 LVEDVI, mL/m2 95.0 ± 30.7 74.3 ± 30.2 -20.7 (-25.6 to -15.8) &lt;0.001 LVESVI, mL/m2 70.0 ± 24.8 50.2 ± 26.8 -19.8 (-24.2 to -15.4) &lt;0.001 LVEF, % 26.8 ± 7.5 33.9 ± 12.6 7.2 (5.2 to 9.2) &lt;0.001 LV GLS (-%) 9.2 ± 3.1 11.0 ± 4.8 1.8 (1.3 to 2.2) &lt;0.001 Patients without LVRR (n = 115) LVEDDI, mm/m2 34.9 ± 6.8 34.1 ± 6.8 -0.8 (-1.3 to -0.3) 0.002 LVESDI, mm/m2 29.5 ± 6.1 28.4 ± 6.4 -1.4 (-1.8 to -0.4) 0.002 LVEDVI, mL/m2 92.0 ± 30.5 83.4 ± 29.8 -8.6 (-12.4 to -4.8) &lt;0.001 LVESVI, mL/m2 67.1 ± 24.4 59.5 ± 25.3 -7.6 (-10.9 to -4.3) &lt;0.001 LVEF, % 27.1 ± 7.4 27.8 ± 7.4 0.7 (-0.2 to 1.6) 0.126 LV GLS (-%) 8.2 ± 2.9 8.7 ± 3.2 0.5 (0.7 to 3.6) &lt;0.001 Patients with LVRR (n = 45) LVEDDI, mm/m2 37.4 ± 5.5 29.8 ± 5.2 -7.5 (-9.1 to -6.0) &lt;0.001 LVESDI, mm/m2 32.2 ± 5.7 21.9 ± 4.4 -10.3 (-11.9 to -8.6) &lt;0.001 LVEDVI, mL/m2 102.7 ± 30.2 51.1 ± 15.0 -51.7 (-61.6 to -41.7) &lt;0.001 LVESVI, mL/m2 77.3 ± 24.5 26.4 ± 11.3 -50.9 (-58.8 to -43.1) &lt;0.001 LVEF, % 26.1 ± 7.9 49.4 ± 9.5 23.9 (20.4 to 27.5) &lt;0.001 LV GLS (-%) 11.9 ± 1.6 16.9 ± 2.7 5.1 (4.2 to 5.9) &lt;0.001 Baseline and Follow-up LV Functional Echocardiographic Data Abstract P818 Figure.

Intramyocardial Angiogenic Cell Precursors in Nonischemic Dilated Cardiomyopathy

2009 ◽  
Vol 17 (4) ◽  
pp. 382-388 ◽  
Author(s):  
Kitipan V Arom ◽  
Permyos Ruengsakulrach ◽  
Michael Belkin ◽  
Montip Tiensuwan
Keyword(s):  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Dilated Cardiomyopathy ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Left Ventricular Ejection ◽  
Cell Group ◽  
Control Group ◽  
Ventricular Ejection Fraction ◽  
Nonischemic Dilated Cardiomyopathy

To determine the efficacy of intramyocardial injection of angiogenic cell precursors in nonischemic dilated cardiomyopathy, 35 patients with nonischemic dilated cardiomyopathy underwent injections of angiogenic cell precursors into the left ventricle (cell group). Seventeen patients with nonischemic dilated cardiomyopathy were matched from the heart failure database to form a control group that was treated medically. Angiogenic cell precursors were obtained from autologous blood, cultured in vitro, and injected into all free-wall areas of the left ventricle in the cell group. After these injections, New York Heart Association functional class improved significantly by 1.1 ± 0.7 classes at 284.7 ± 136.2 days, and left ventricular ejection fraction improved in 71.4% of patients (25/35); the mean increase in left ventricular ejection fraction was 4.4% ± 10.6% at 192.7 ± 135.1 days. Improved quality of life was demonstrated by better physical function, role-physical, general health, and vitality domains in a short-form health survey at the 3-month follow-up. In the control group, there were no significant improvements in left ventricular ejection fraction or New York Heart Association class which increased by 0.6 ± 0.8 classes. It was concluded that intramyocardial angiogenic cell precursor injection is probably effective in the treatment of nonischemic dilated cardiomyopathy. Disclosures and Freedom of Investigation Professor Michael Belkin is an advisory board member, a minor shareholder, and receives a consulting fee from TheraVitae Co. Ltd. However, the authors had full control of the study, methods used, outcome measurements, data analysis, and production of the written report.

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