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European Journal of Nuclear Medicine and Molecular Imaging

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01.04.2016 | Original Article

Predictors of ventricular remodelling in patients with reperfused acute myocardial infarction and left ventricular dysfunction candidates for bone marrow cell therapy: insights from the BONAMI trial

verfasst von: Alain Manrique, Patricia Lemarchand, Béatrice Delasalle, Olivier Lairez, Catherine Sportouch-Duckan, Guillaume Lamirault, Philippe Le Corvoisier, Yannick Neuder, Marjorie Richardson, Alain Lebon, Jérome Roncalli, Christophe Piot, Jean-Noel Trochu, Emmanuel Teiger, Claude Hossein-Foucher, Thierry Le Tourneau

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 4/2016

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Abstract

Purpose

Few data are available regarding the relation of left ventricular (LV) mechanical dyssynchrony to remodelling after acute myocardial infarction (MI) and stem cell therapy. We evaluated the 1-year time course of both LV mechanical dyssynchrony and remodelling in patients enrolled in the BONAMI trial, a randomized, multicenter controlled trial assessing cell therapy in patients with reperfused MI.

Methods

Patients with acute MI and ejection fraction (EF) ≤ 45 % were randomized to cell therapy or to control and underwent thallium single-photon emission computed tomography (SPECT), radionuclide angiography, and echocardiography at baseline, 3 months, and 1 year. Eighty-three patients with a comprehensive 1-year follow-up were included. LV dyssynchrony was assessed by the standard deviation (SD) of the LV phase histogram using radionuclide angiography. Remodelling was defined as a 20 % increase in LV end-systolic volume index (LVESVI) at 1 year.

Results

At baseline, LVEF, wall motion score index, and perfusion defect size were significantly impaired in the 43 patients (52 %) with LV remodelling (all p < 0.001), without significant increase in LV mechanical dyssynchrony. During follow-up, there was a progressive increase in LV SD (p = 0.01). Baseline independent predictors of LV remodelling were perfusion SPECT defect size (p = 0.001), LVEF (p = 0.01) and a history of hypertension (p = 0.043). Bone marrow cell therapy did not affect the time-course of LV remodelling and dyssynchrony.

Conclusions

LV remodelling 1 year after reperfused MI is associated with progressive LV dyssynchrony and is related to baseline infarct size and ejection fraction, without impact of cell therapy on this process.

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Titel: Predictors of ventricular remodelling in patients with reperfused acute myocardial infarction and left ventricular dysfunction candidates for bone marrow cell therapy: insights from the BONAMI trial
verfasst von: Alain Manrique
Patricia Lemarchand
Béatrice Delasalle
Olivier Lairez
Catherine Sportouch-Duckan
Guillaume Lamirault
Philippe Le Corvoisier
Yannick Neuder
Marjorie Richardson
Alain Lebon
Jérome Roncalli
Christophe Piot
Jean-Noel Trochu
Emmanuel Teiger
Claude Hossein-Foucher
Thierry Le Tourneau
Publikationsdatum: 01.04.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 4/2016
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-015-3279-z

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusions

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