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. 2008 Dec;16(12):436-9.
doi: 10.1007/BF03086194.

Bone marrow cell therapy after acute myocardial infarction: the HEBE trial in perspective, first results

Affiliations

Bone marrow cell therapy after acute myocardial infarction: the HEBE trial in perspective, first results

A van der Laan et al. Neth Heart J. 2008 Dec.

Abstract

During the last decennium, the role of bone marrow mononuclear cells (BMMC) has been underscored in the healing process after acute myocardial infarction (AMI). Although these cells improve left ventricular recovery after AMI in experimental studies, results from large-scale randomised trials investigating BMMC therapy in patients with AMI have shown contradictory results. To address this issue the HEBE study was designed, a multicentre, randomised trial, evaluating the effects of intracoronary infusion of BMMCs and the effects of intracoronary infusion of peripheral blood mononuclear cells after primary percutaneous coronary intervention. The primary endpoint of the HEBE trial is the change in regional myocardial function in dysfunctional segments at four months relative to baseline, based on segmental analysis as measured by magnetic resonance imaging. The results from the HEBE trial will provide detailed information about the effects of intracoronary BMMC therapy on post-infarct left ventricular recovery. In addition, further analysis of the data and material obtained may provide important mechanistic insights into the contribution of BMMCs to natural recovery from AMI as well as the response to cell therapy. This may significantly contribute to the development of improved cell-based therapies, aiming at optimising post-infarct recovery and preventing heart failure. (Neth Heart J 2008;16:436-9.).

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Figures

Figure 1
Figure 1
The effect of intracoronary infusion ofBMMCs on LVEF after AMI. The LVEF significantly increased from 45.0±6.3% at baseline to 47.2±6.5% (p=0.03) at four months of follow-up as measured by MRI (modified from Hirsch et al. 19).
Figure 2
Figure 2
Change in systolic wall thickening after intracoronary BMMC infusion in (A) dysfunctional segments at baseline versus normal segments (n=24) and in (B) dysfunctional segments stratified by extent of hyperenhancement (n=1 9). Improvement in systolic wall thickening was 1.0±0.6 mm in segments with 0-25% hyperenhancement, 0.9±1.2 mm in 26-75% and 1.0±1.4 mm in 76-100%. Base=baseline, ES=end-systolic, ED=end-diastolic, FU=follow-up, LGE=lategadolinium enhancement (Hirsch et al., reprinted with permission of John Wiley & Sons, Inc.).

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