Abstract 5759: Intramyocardial Application Of Erythropoietin And Expanded Endothelial Progenitor Cells Improve Regional Left Ventricular Function After Induced Myocardial Infarction In Rats

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Andreas Stein ◽  
Antti Saraste ◽  
Marcus Makowski ◽  
Sandra Kühnel ◽  
Elisabeth Weidl ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Left Ventricular Function ◽  
Progenitor Cells ◽  
Ventricular Function ◽  
Endothelial Progenitor Cells ◽  
Left Ventricular ◽  
Border Zone ◽  
Control Group ◽  
Endothelial Progenitor ◽  
Regional Left Ventricular Function

Background : Experimental studies showed that application of expanded endothelial progenitor cells (eEPC) after myocardial infarction improves cardiac function by enhancing vasculogenesis and by paracrine effects. Erythropoietin beta (EPO) could further improve myocardial function through its anti-apoptotic properties. Methods : Acute myocardial ischemia was induced by ligation of the left anterior descending coronary artery of 23 male athymic nude rats and reperfusion was initiated after 30 minutes. Either 1×10^6 eEPC alone (n=8), 50 IU erythropoietin beta alone (n=7) or eEPC and EPO (n=8) were injected intramyocardially into the border zone of the ischemic area. eEPC were attained by expanding CD34+ cells isolated from cord blood in endothelial medium for 6 –10 passages. A control group did not receive cells or erythropoietin (n=5). After 4 weeks global and regional left ventricular function was measured by MRI in 2- and 4-chamber long-axis series (Philips Achieva MR Scanner). Immunhistology was used to determine vessel densitiy (SMC actin) and infiltrating monocytes (CD68) after 3 days (n=15) and 4 weeks. Results : Global left ventricular function after 4 weeks was higher in rats that received eEPC alone (58±3%, p=.02) or eEPC + EPO (58±6%, p=.01) compared to the control group (54±5%). No changes were found for rats treated with EPO alone (52±4%). Analysis of the regional wall movement showed a further improvement of the movement of the antero-lateral segments only in rats that obtained eEPC + EPO. The number of CD68+ mononuclear cells after 3 days was highest in rats that were treated with eEPC + EPO. This was associated with an increase in vessel density after 4 weeks. In vitro experiments revealed a dose-dependent inhibition of apoptosis by EPO in eEPC. Conclusion: Intramyocardial transplantation of eEPCs + EPO further improved anterolateral wall motion as compared to EPC alone. Improved eEPC survival, alterations in local inflammatory responses and neovascularization may contribute to this effect.

scholarly journals Plasma Brain Natriuretic Peptide (BNP) as an Indicator of Left Ventricular Function, Early Outcome and Mechanical Complications after Acute Myocardial Infarction

2011 ◽  
Vol 5 ◽  
pp. CMC.S7189 ◽  
Author(s):  
A. Fazlinezhad ◽  
M. Khadem Rezaeian ◽  
H. Yousefzadeh ◽  
K. Ghaffarzadegan ◽  
M. Khajedaluee
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Left Ventricular Function ◽  
Ventricular Function ◽  
Natriuretic Peptide ◽  
Significant Relationship ◽  
Left Ventricular ◽  
Control Group ◽  
Cross Sectional ◽  
Mechanical Complications

Aims This study investigated the prognostic value of B type natriuretic peptide (BNP) in acute myocardial infarction (AMI) patients and its relation with left ventricular function and post-myocardial infarction complications. Methods In this cross-sectional study, plasma BNP level was measured for 42 consecutive patients (mean ± SD: 61.6 ± 10.85 years old) with acute ST elevation myocardial infarction (MI) and 42 healthy, age and gender matched subjects. Result BNP level in AMI patients were significantly higher than control group (@ P < 0.001). Regarding to infarct location, the highest BNP level measured in inferoposterior MI (BNP = 4436.63 ± 6188.159 pg/ml) and the lowest one indicated in standalone inferior MI (BNP = 598.83 ± 309.867 pg/ml ( P = 0.071). There was significant reverse relation between BNP and EF ( P = 0.006, OR = −0.47) and a significant relationship between BNP and killip classification ( P = 0.036). There was no significant relation between diastolic and right-ventricular function and BNP level ( P = 0.61, P = 0.21). The highest BNP level was detected in LV septal rupture and false aneurysm ( P = 0.02) and in ventricular tachycardia, but without significant relationship ( P = 0.25). Conclusion After the onset of AMI, BNP blood level can be used as an important predictor for left ventricular dysfunction, killip classification, early mechanical complications and cardiac death.

Abstract 3420: Effects on Myocardial Perfusion at 3 and 15 Months in Recanalized Chronic Total Occlusions - Randomized Comparison of Blood-Derived Progenitor Cells and Inactive Serum

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Holger Thiele ◽  
Andreas Schuster ◽  
Sandra Erbs ◽  
Volker Adams ◽  
Karsten Lenk ◽  
...  
Keyword(s):  
Myocardial Perfusion ◽  
Left Ventricular Function ◽  
Infarct Size ◽  
Progenitor Cells ◽  
Ventricular Function ◽  
Left Ventricular ◽  
Control Group ◽  
Chronic Total Occlusions ◽  
And Function

Background: MRI is an excellent diagnostic tool for serial assessment of changes in myocardial perfusion, left ventricular function, and infarct size. In chronic total occlusions (CTO) the effects of recanalization on perfusion and function are contradictory and might depend primarily on viability. Circulating progenitor cells (CPC) injected intracoronarily after successful CTO recanalization might improve perfusion and function. Methods and results: Twenty-eight patients with reperfused CTO were randomized to either CPC’s or inactive serum (control), which were infused into the target vessel. First-pass myocardial perfusion MRI at rest and stress using adenosine at standard dose revealed a significant improvement of the myocardial perfusion reserve index (MPRI) in the affected segments. The baseline MPRI in affected segments was 1.50±0.17 in CPC versus 1.46±0.16 in control (p=0.62). In CPC the MPRI improved to 1.76±0.16 (p<0.001) at 3 and 1.82±0.20 (p<0.001) at 15 months; in control the change was 1.58±0.10 (p=0.01) at 3 and 1.61±0.08 (p=0.004) at 15 months follow-up. However, the MPRI recovery was significantly better in CPC as compared to control at 3 (p=0.004) and 15 months (p=0.005). In remote myocardium the MPRI was 1.70±0.30 and 1.69±0.25 (p<0.01 versus affected segments), respectively. At follow-up there was no significant improvement for both groups. The change in MPRI at 3 and 15 months was correlated with a change in overall infarct size for CPC (3 months: r=−0.68, p<0.02; 15 months: r=−0.81, p=0.001), whereas in control there was no correlation (r=−0.38, p=0.26; 15 months: r=−0.21, p=0.56). Infarct transmurality influenced MPRI improvement at follow-up. CPC patients had a trend towards more improved segments in particular those with higher transmurality (p=0.06). Conclusions: Analysis of serial contrast-enhanced MRI suggests that intracoronary application of CPC post recanalization of CTO is associated with improved myocardial perfusion and subsequent improved recovery of left ventricular function as compared to a control group at mid- and long-term follow-up. Further investigations of the pathophysiological CPC effects on macro- and microvascular function are required.

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