The effect of bone marrow-derived cells on diastolic function and exercise capacity in patients after acute myocardial infarction

Background: The early- to mid-term impact of bone-marrow-derived stem cells (BMC) on diastolic function and exercise capacity after acute myocardial infarction (AMI) remains controversial. We performed a systematic analysis to assess whether BMC transfer is related to an early improvement in diastolic function and exercise capacity after AMI. Methods: Randomized controlled trials (RCTs) of BMC therapy after AMI were extracted from MEDLINE, EMBASE and CENTRAL and analyzed for a change in tissue Doppler annular early (Ea) and late diastolic (Aa) velocities, mitral inflow E velocity to tissue Doppler Ea (E/Ea) ratio, exercise time and exercise capacity. Results: A total of 365 patients were included from 6 trials. A greater improvement was observed in the E/Ea ratio after 1 year in the BMC group compared to the control group. Additionally, the BMC-treated patients had a larger improvement in exercise time, ventilation/CO2 production (VE/VCO2 slope) and respiratory exchange ratio (RER) after 1 year. Conclusion: The results indicate that intracoronary BMC treatment in AMI patients leads to a mid-term improvement in diastolic function and exercise capacity. (C) 2012 Elsevier B.V. All rights reserved.