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Article: Comparative evaluation of long-term clinical efficacy with catheter-based percutaneous intramyocardial autologous bone marrow cell implantation versus laser myocardial revascularization in patients with severe coronary artery disease

TitleComparative evaluation of long-term clinical efficacy with catheter-based percutaneous intramyocardial autologous bone marrow cell implantation versus laser myocardial revascularization in patients with severe coronary artery disease
Authors
Issue Date2007
PublisherMosby, Inc. The Journal's web site is located at http://www.elsevier.com/locate/ahj
Citation
American Heart Journal, 2007, v. 154 n. 5, p. 982.e1-982.e6 How to Cite?
Abstract
Background: Catheter-based percutaneous laser myocardial revascularization (PMR) and intramyocardial direct bone marrow (BM) cell implantation have been investigated to treat patients with severe coronary artery disease (CAD). In both therapeutic approaches, direct local myocardial injury might be a common mechanism to induce therapeutic angiogenesis. Methods: We studied the long-term clinical outcome in 16 patients with severe CAD who received either catheter-based PMR (n = 8) or intramyocardial autologous BM cell implantation (n = 8) as guided by electromechanical mapping. Results: There were no significant differences in the baseline characteristics and the number of injection versus the number of laser pulse delivered between the 2 groups (P > .05). As compared with baseline, the New York Heart Association functional class and the number of anginal episodes were significantly reduced at 3- and 6-month follow-up in both BM and PMR groups (P < .05). However, the improvement in the New York Heart Association class and the reduction in anginal episodes at 18 months were only persisted in the BM group (P < .05) but not in the PMR group (P > .05). Furthermore, there were significant improvements in exercise time at 6- and 18-month follow-up, and the extent of stress-induced perfusion single-photon emission computed tomography defects at 6-month follow-up in BM group, as compared with baseline (all P < .05), but not in the PMR group (all P > .05). As compared with baseline, there were no significant changes in the total quality of life scores during follow-up in both groups (all P > .05). Conclusions: The results of this study demonstrated that the catheter-based intramyocardial autologous BM cell implantation might be more effective than PMR in improving symptoms and exercise capacity in patients with severe CAD. The beneficial effect of direct intramyocardial injection was over and beyond those noted in patients treated with PMR, suggesting a potential direct therapeutic effect of BM cells, rather than local myocardial injury alone on chronic ischemic myocardium. © 2007 Mosby, Inc. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/77817
ISSN
2013 Impact Factor: 4.555
ISI Accession Number ID
References

 

Author Affiliations
  1. The University of Hong Kong
  2. Harvard Medical School
  3. John Hunter Hospital
  4. Hong Kong Sanatorium and Hospital
DC FieldValueLanguage
dc.contributor.authorTse, HFen_HK
dc.contributor.authorThambar, Sen_HK
dc.contributor.authorKwong, YLen_HK
dc.contributor.authorRowlings, Pen_HK
dc.contributor.authorBellamy, Gen_HK
dc.contributor.authorMcCrohon, Jen_HK
dc.contributor.authorBastian, Ben_HK
dc.contributor.authorChan, JKFen_HK
dc.contributor.authorLo, Gen_HK
dc.contributor.authorHo, CLen_HK
dc.contributor.authorParker, Aen_HK
dc.contributor.authorHauser, THen_HK
dc.contributor.authorLau, CPen_HK
dc.date.accessioned2010-09-06T07:36:03Z-
dc.date.available2010-09-06T07:36:03Z-
dc.date.issued2007en_HK
dc.identifier.citationAmerican Heart Journal, 2007, v. 154 n. 5, p. 982.e1-982.e6en_HK
dc.identifier.issn0002-8703en_HK
dc.identifier.urihttp://hdl.handle.net/10722/77817-
dc.description.abstractBackground: Catheter-based percutaneous laser myocardial revascularization (PMR) and intramyocardial direct bone marrow (BM) cell implantation have been investigated to treat patients with severe coronary artery disease (CAD). In both therapeutic approaches, direct local myocardial injury might be a common mechanism to induce therapeutic angiogenesis. Methods: We studied the long-term clinical outcome in 16 patients with severe CAD who received either catheter-based PMR (n = 8) or intramyocardial autologous BM cell implantation (n = 8) as guided by electromechanical mapping. Results: There were no significant differences in the baseline characteristics and the number of injection versus the number of laser pulse delivered between the 2 groups (P > .05). As compared with baseline, the New York Heart Association functional class and the number of anginal episodes were significantly reduced at 3- and 6-month follow-up in both BM and PMR groups (P < .05). However, the improvement in the New York Heart Association class and the reduction in anginal episodes at 18 months were only persisted in the BM group (P < .05) but not in the PMR group (P > .05). Furthermore, there were significant improvements in exercise time at 6- and 18-month follow-up, and the extent of stress-induced perfusion single-photon emission computed tomography defects at 6-month follow-up in BM group, as compared with baseline (all P < .05), but not in the PMR group (all P > .05). As compared with baseline, there were no significant changes in the total quality of life scores during follow-up in both groups (all P > .05). Conclusions: The results of this study demonstrated that the catheter-based intramyocardial autologous BM cell implantation might be more effective than PMR in improving symptoms and exercise capacity in patients with severe CAD. The beneficial effect of direct intramyocardial injection was over and beyond those noted in patients treated with PMR, suggesting a potential direct therapeutic effect of BM cells, rather than local myocardial injury alone on chronic ischemic myocardium. © 2007 Mosby, Inc. All rights reserved.en_HK
dc.languageengen_HK
dc.publisherMosby, Inc. The Journal's web site is located at http://www.elsevier.com/locate/ahjen_HK
dc.relation.ispartofAmerican Heart Journalen_HK
dc.rightsAmerican Heart Journal. Copyright © Mosby, Inc.en_HK
dc.subject.meshBone Marrow Transplantation - methodsen_HK
dc.subject.meshCoronary Disease - radionuclide imaging - surgeryen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshFollow-Up Studiesen_HK
dc.subject.meshHeart Catheterization - methodsen_HK
dc.subject.meshHumansen_HK
dc.subject.meshLaser Therapy - methodsen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshMyocardial Revascularization - methodsen_HK
dc.subject.meshMyocardiumen_HK
dc.subject.meshRetrospective Studiesen_HK
dc.subject.meshSeverity of Illness Indexen_HK
dc.subject.meshTime Factorsen_HK
dc.subject.meshTomography, Emission-Computed, Single-Photonen_HK
dc.subject.meshTransplantation, Autologousen_HK
dc.subject.meshTreatment Outcomeen_HK
dc.titleComparative evaluation of long-term clinical efficacy with catheter-based percutaneous intramyocardial autologous bone marrow cell implantation versus laser myocardial revascularization in patients with severe coronary artery diseaseen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0002-8703&volume=154&issue=5&spage=982.e1&epage=982.e6 &date=2007&atitle=Comparative+evaluation+of+long-term+clinical+efficacy+with+catheter-based+percutaneous+intramyocardial+autologous+bone+marrow+cell+implantation+versus+laser+myocardial+revascularization+in+patients+with+severe+coronary+artery+diseaseen_HK
dc.identifier.emailTse, HF:hftse@hkucc.hku.hken_HK
dc.identifier.emailKwong, YL:ylkwong@hku.hken_HK
dc.identifier.authorityTse, HF=rp00428en_HK
dc.identifier.authorityKwong, YL=rp00358en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.ahj.2007.07.021en_HK
dc.identifier.pmid17967607en_HK
dc.identifier.scopuseid_2-s2.0-35448966661en_HK
dc.identifier.hkuros146457en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-35448966661&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume154en_HK
dc.identifier.issue5en_HK
dc.identifier.spage982.e1en_HK
dc.identifier.epage982.e6en_HK
dc.identifier.isiWOS:000251146800028-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridTse, HF=7006070805en_HK
dc.identifier.scopusauthoridThambar, S=6508108817en_HK
dc.identifier.scopusauthoridKwong, YL=7102818954en_HK
dc.identifier.scopusauthoridRowlings, P=7003519846en_HK
dc.identifier.scopusauthoridBellamy, G=7006844978en_HK
dc.identifier.scopusauthoridMcCrohon, J=6602810028en_HK
dc.identifier.scopusauthoridBastian, B=7005685003en_HK
dc.identifier.scopusauthoridChan, JKF=7403287057en_HK
dc.identifier.scopusauthoridLo, G=7101880732en_HK
dc.identifier.scopusauthoridHo, CL=7404653628en_HK
dc.identifier.scopusauthoridParker, A=7403267925en_HK
dc.identifier.scopusauthoridHauser, TH=7006380610en_HK
dc.identifier.scopusauthoridLau, CP=7401968501en_HK

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