BACKGROUND Studies indicate no clear impact of intracoronary injection of bone-marrow unselected mononuclear cells (BM-MNC) after acute myocardial infarction (AMI) on left-ventricular function (LVEF). Strain parameters by cardiovascular magnetic resonance (CMR) have been proposed to be more sensitive to functional changes of the heart. The aim of the present study was to assess changes of global longitudinal (GLS) and circumferential strain (GCS) in a group of patients treated with BM-MNC after AMI. METHODS One-hundred and forty-nine patients with successfully reperfused AMI and LV dysfunction (LVEF<45%) were retrospectively included into this sub-study of the SWISS-AMI multicentre trial. Patients were divided into control (N = 54), early (5-7 days after AMI, N = 51) and late BM-MNC treatment groups (3-4 weeks, N = 44). The endpoint was the change of GLS and GCS as obtained from cine sequences 4 and 12 months after AMI using feature tracking algorithm. RESULTS In unadjusted analyses, the absolute change of GLS for the early treatment group from baseline to 4 months was 2.5 ± 4.3 (p < 0.01), to 12 months 2.7 ± 5.7% (p = 0.004). For late treatment, it was 1.5 ± 4.0% (p = 0.039, 4 months) and 2.5 ± 5.6% (p = 0.015, 12 months). For controls 0.7 ± 4.7% (p = 0.378), 0.8 ± 3.9% (p = 0.253) respectively. Adjusting for different baseline values, neither an overall treatment effect (both time-points) of BM-MNC nor a treatment time-related (only early or late) effect could be shown for all functional parameters. CONCLUSIONS Among patients after AMI with successful reperfusion and LV dysfunction, intracoronary infusion of BM-MNC early or late after AMI did not improve global strain parameters at 4- or 12-months follow-up. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT00355186.

中文翻译：

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心肌梗死后早期和晚期冠状动脉内骨髓源性单核细胞注射对CMR源性心肌应变的影响。

背景研究表明，急性心肌梗死 (AMI) 后冠状动脉内注射未选择的骨髓单核细胞 (BM-MNC) 对左心室功能 (LVEF) 没有明显影响。已经提出心血管磁共振（CMR）的应变参数对心脏的功能变化更敏感。本研究的目的是评估 AMI 后接受 BM-MNC 治疗的一组患者的整体纵向 (GLS) 和圆周应变 (GCS) 的变化。方法 149 名成功再灌注 AMI 和 LV 功能障碍（LVEF<45%）的患者被回顾性纳入 SWISS-AMI 多中心试验的子研究。患者分为对照组（N = 54）、早期（AMI 后 5-7 天，N = 51）和晚期 BM-MNC 治疗组（3-4 周，N = 44）。终点是使用特征跟踪算法从 AMI 后 4 个月和 12 个月的电影序列中获得的 GLS 和 GCS 的变化。结果 在未经调整的分析中，早期治疗组从基线到 4 个月的 GLS 绝对变化为 2.5 ± 4.3 (p < 0.01)，到 12 个月为 2.7 ± 5.7% (p = 0.004)。对于晚期治疗，分别为 1.5 ± 4.0%（p = 0.039，4 个月）和 2.5 ± 5.6%（p = 0.015，12 个月）。对照组分别为 0.7 ± 4.7% (p = 0.378)、0.8 ± 3.9% (p = 0.253)。调整不同的基线值后，BM-MNC 的整体治疗效果（两个时间点）和治疗时间相关（仅早期或晚期）效果都无法显示所有功能参数。结论 AMI 后成功再灌注和左室功能不全的患者中，AMI 后早期或晚期冠状动脉内输注 BM-MNC 在 4 或 12 个月的随访中并未改善整体应变参数。临床试验注册网址：http://www.clinicaltrials.gov。唯一标识符：NCT00355186。