Seitz, Andreas, Wollert, Kai C., Meyer, Gerd P., Mueller-Ehmsen, Jochen, Tschoepe, Carsten, May, Andreas E., Empen, Klaus, Chorianopoulos, Emmanuel, Ritter, Benedikta, Pirr, Jens, Arseniev, Lubomir, Heuft, Hans-Gert, Ganser, Arnold, Abu-Zaid, Eed, Katus, Hugo A., Felix, Stephan B., Gawaz, Meinrad P., Schultheiss, Heinz-Peter, Ladage, Dennis ORCID: 0000-0002-4512-0917, Bauersachs, Johann, Mahrholdt, Heiko and Greulich, Simon (2020). Adenosine stress perfusion cardiac magnetic resonance imaging in patients undergoing intracoronary bone marrow cell transfer after ST-elevation myocardial infarction: the BOOST-2 perfusion substudy. Clin. Res. Cardiol., 109 (5). S. 539 - 549. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1861-0692

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Abstract

Aims In the placebo-controlled, double-blind BOne marrOw transfer to enhance ST-elevation infarct regeneration (BOOST) 2 trial, intracoronary autologous bone marrow cell (BMC) transfer did not improve recovery of left ventricular ejection fraction (LVEF) at 6 months in patients with ST-elevation myocardial infarction (STEMI) and moderately reduced LVEF. Regional myocardial perfusion as determined by adenosine stress perfusion cardiac magnetic resonance imaging (S-CMR) may be more sensitive than global LVEF in detecting BMC treatment effects. Here, we sought to evaluate (i) the changes of myocardial perfusion in the infarct area over time (ii) the effects of BMC therapy on infarct perfusion, and (iii) the relation of infarct perfusion to LVEF recovery at 6 months. Methods and results In 51 patients from BOOST-2 (placebo, n = 10; BMC, n = 41), S-CMR was performed 5.1 +/- 2.9 days after PCI (before placebo/BMC treatment) and after 6 months. Infarct perfusion improved from baseline to 6 months in the overall patient cohort as reflected by the semi-quantitative parameters, perfusion defect-infarct size ratio (change from 0.54 +/- 0.20 to 0.43 +/- 0.22; P = 0.006) and perfusion defect-upslope ratio (0.54 +/- 0.23 to 0.68 +/- 0.22; P < 0.001), irrespective of randomised treatment. Perfusion defect-upslope ratio at baseline correlated with LVEF recovery (r = 0.62; P < 0.001) after 6 months, with a threshold of 0.54 providing the best sensitivity (79%) and specificity (74%) (area under the curve, 0.79; 95% confidence interval, 0.67-0.92). Conclusion Infarct perfusion improves from baseline to 6 months and predicts LVEF recovery in STEMI patients undergoing early PCI. Intracoronary BMC therapy did not enhance infarct perfusion in the BOOST-2 trial. Graphic abstract

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Seitz, AndreasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wollert, Kai C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Meyer, Gerd P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mueller-Ehmsen, JochenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tschoepe, CarstenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
May, Andreas E.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Empen, KlausUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Chorianopoulos, EmmanuelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ritter, BenediktaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pirr, JensUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Arseniev, LubomirUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Heuft, Hans-GertUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ganser, ArnoldUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Abu-Zaid, EedUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Katus, Hugo A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Felix, Stephan B.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gawaz, Meinrad P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schultheiss, Heinz-PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ladage, DennisUNSPECIFIEDorcid.org/0000-0002-4512-0917UNSPECIFIED
Bauersachs, JohannUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mahrholdt, HeikoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Greulich, SimonUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-335840
DOI: 10.1007/s00392-019-01537-4
Journal or Publication Title: Clin. Res. Cardiol.
Volume: 109
Number: 5
Page Range: S. 539 - 549
Date: 2020
Publisher: SPRINGER HEIDELBERG
Place of Publication: HEIDELBERG
ISSN: 1861-0692
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
LEFT-VENTRICULAR FUNCTION; MICROVASCULAR OBSTRUCTION; SEGMENT ELEVATION; PROGNOSTIC VALUE; THERAPY; IMPROVE; SIZEMultiple languages
Cardiac & Cardiovascular SystemsMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/33584

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