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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
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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
 
AuthorsTse, HF1
Thambar, S3
Kwong, YL1
Rowlings, P3
Bellamy, G3
McCrohon, J3
Bastian, B3
Chan, JKF4
Lo, G4
Ho, CL4
Parker, A2
Hauser, TH2
Lau, CP1
 
Issue Date2007
 
PublisherMosby, Inc. The Journal's web site is located at http://www.elsevier.com/locate/ahj
 
CitationAmerican Heart Journal, 2007, v. 154 n. 5, p. 982.e1-982.e6 [How to Cite?]
DOI: http://dx.doi.org/10.1016/j.ahj.2007.07.021
 
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.
 
ISSN0002-8703
2012 Impact Factor: 4.497
2012 SCImago Journal Rankings: 2.999
 
DOIhttp://dx.doi.org/10.1016/j.ahj.2007.07.021
 
ISI Accession Number IDWOS:000251146800028
 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorTse, HF
 
dc.contributor.authorThambar, S
 
dc.contributor.authorKwong, YL
 
dc.contributor.authorRowlings, P
 
dc.contributor.authorBellamy, G
 
dc.contributor.authorMcCrohon, J
 
dc.contributor.authorBastian, B
 
dc.contributor.authorChan, JKF
 
dc.contributor.authorLo, G
 
dc.contributor.authorHo, CL
 
dc.contributor.authorParker, A
 
dc.contributor.authorHauser, TH
 
dc.contributor.authorLau, CP
 
dc.date.accessioned2010-09-06T07:36:03Z
 
dc.date.available2010-09-06T07:36:03Z
 
dc.date.issued2007
 
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.
 
dc.description.natureLink_to_subscribed_fulltext
 
dc.identifier.citationAmerican Heart Journal, 2007, v. 154 n. 5, p. 982.e1-982.e6 [How to Cite?]
DOI: http://dx.doi.org/10.1016/j.ahj.2007.07.021
 
dc.identifier.doihttp://dx.doi.org/10.1016/j.ahj.2007.07.021
 
dc.identifier.epage982.e6
 
dc.identifier.hkuros146457
 
dc.identifier.isiWOS:000251146800028
 
dc.identifier.issn0002-8703
2012 Impact Factor: 4.497
2012 SCImago Journal Rankings: 2.999
 
dc.identifier.issue5
 
dc.identifier.openurl
 
dc.identifier.pmid17967607
 
dc.identifier.scopuseid_2-s2.0-35448966661
 
dc.identifier.spage982.e1
 
dc.identifier.urihttp://hdl.handle.net/10722/77817
 
dc.identifier.volume154
 
dc.languageeng
 
dc.publisherMosby, Inc. The Journal's web site is located at http://www.elsevier.com/locate/ahj
 
dc.publisher.placeUnited States
 
dc.relation.ispartofAmerican Heart Journal
 
dc.relation.referencesReferences in Scopus
 
dc.rightsAmerican Heart Journal. Copyright © Mosby, Inc.
 
dc.subject.meshBone Marrow Transplantation - methods
 
dc.subject.meshCoronary Disease - radionuclide imaging - surgery
 
dc.subject.meshFemale
 
dc.subject.meshFollow-Up Studies
 
dc.subject.meshHeart Catheterization - methods
 
dc.subject.meshHumans
 
dc.subject.meshLaser Therapy - methods
 
dc.subject.meshMale
 
dc.subject.meshMiddle Aged
 
dc.subject.meshMyocardial Revascularization - methods
 
dc.subject.meshMyocardium
 
dc.subject.meshRetrospective Studies
 
dc.subject.meshSeverity of Illness Index
 
dc.subject.meshTime Factors
 
dc.subject.meshTomography, Emission-Computed, Single-Photon
 
dc.subject.meshTransplantation, Autologous
 
dc.subject.meshTreatment Outcome
 
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 disease
 
dc.typeArticle
 
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<contributor.author>Rowlings, P</contributor.author>
<contributor.author>Bellamy, G</contributor.author>
<contributor.author>McCrohon, J</contributor.author>
<contributor.author>Bastian, B</contributor.author>
<contributor.author>Chan, JKF</contributor.author>
<contributor.author>Lo, G</contributor.author>
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<description.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 &gt; .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 &lt; .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 &lt; .05) but not in the PMR group (P &gt; .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 &lt; .05), but not in the PMR group (all P &gt; .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 &gt; .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. &#169; 2007 Mosby, Inc. All rights reserved.</description.abstract>
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Author Affiliations
  1. The University of Hong Kong
  2. Harvard Medical School
  3. John Hunter Hospital
  4. Hong Kong Sanatorium and Hospital