Aims: Recent data suggest that the administration of bone marrow-derived stem cells(BMSC) might improve myocardial perfusion and left ventricular(LV) function after acute myocardial infarction(AMI). The aim of this st...Aims: Recent data suggest that the administration of bone marrow-derived stem cells(BMSC) might improve myocardial perfusion and left ventricular(LV) function after acute myocardial infarction(AMI). The aim of this study was to assess spontaneous mobilization of BMSC expressing the haematopoietic and endothelial progenitor cell-associated antigen CD34+after AMI and its relation to post-infarction remodelling. Methods and results: Peripheral blood concentration of CD34+BMSC was measured by flow cytometry in 54 patients with AMI, 26 patients with chronic stable angina(CSA), and 43 normal healthy subjects. In patients with AMI, LV function was measured by 2D-echocardio-graphy. Eighteen AMI patients were reassessed at 1 year. BMSC concentration was higher in patients with AMI(mean peak value: 7.04±6.27 cells/μL), than in patients with CSA(3.80±2.12 cells/μL, P=0.036) and in healthy controls(1.87±1.52 cells/μL, P< 0.001). At multivariable analysis statin use(P< 0.001), primary percutaneous intervention(P=0.048) and anterior AMI(P=0.05) were the only independent predictors of increased BMSC mobilization after AMI. In the 28 patients without subsequent acute coronary events reassessed at 1 year follow-up,CD34+cell concentration was an independent predictor of global and regional improvement of LV function(r=0.52, P=0.004 and r=-0.41, P=0.03, respectively). Conclusion: AMI is followed by enhanced spontaneous mobilization of BMSC, in particular, in patients on statin therapy and following a primary percutaneous intervention. More importantly persistent spontaneous mobilization of BMSC might contribute to determine a more favourable post-AMI remodelling.展开更多
OBJECTIVES:We sought to determine the association between patent foramen ovale(PFO), atrial septal aneurysm(ASA), and stroke prospectively in a unselected population sample. BACKGROUND: The disputed relationship betwe...OBJECTIVES:We sought to determine the association between patent foramen ovale(PFO), atrial septal aneurysm(ASA), and stroke prospectively in a unselected population sample. BACKGROUND: The disputed relationship between PFO and stroke reflects methodologic weaknesses in studies using invalid controls, unblinded transesophageal echocardiography examinations, and data that are unadjusted for age or comorbidity. METHODS: The use of transesophageal echocardiography to identify PFO was performed by a single echocardiographer using standardized definitions in 585 randomly sampled, Olmsted County(Minnesota) subjects age 45 years or older participating in the Stroke Prevention: Assessment of Risk in a Community(SPARC) study. RESULTS: A PFO was identified in 140(24.3% ) subjects and ASA in 11(1.9% ) subjects. Of the 140 subjects with PFO, 6(4.3% ) had an ASA; of the 437 subjects without PFO, 5 had an ASA(1.1% , two-sided Fisher exact test, p=0.028). During a median follow-up of 5.1 years, cerebrovascular events(cerebrovascular disease-related death, ischemic stroke, transient ischemic attack) occurred in 41 subjects. After adjustment for age and comorbidity, PFO was not a significant independent predictor of stroke(hazard ratio 1.46, 95% confidence interval 0.74 to 2.88, p=0.28). The risk of a cerebrovascular event among subjects with ASA was nearly four times higher than that in those without ASA(hazard ratio 3.72, 95% confidence interval 0.88 to 15.71, p=0.074). CONCLUSIONS: These prospective population-based data suggest that, after correction for age and comorbidity, PFO is not an independent risk factor for future cerebrovascular events in the general population. A larger study is required to test the putative stroke risk associated with ASA.展开更多
文摘Aims: Recent data suggest that the administration of bone marrow-derived stem cells(BMSC) might improve myocardial perfusion and left ventricular(LV) function after acute myocardial infarction(AMI). The aim of this study was to assess spontaneous mobilization of BMSC expressing the haematopoietic and endothelial progenitor cell-associated antigen CD34+after AMI and its relation to post-infarction remodelling. Methods and results: Peripheral blood concentration of CD34+BMSC was measured by flow cytometry in 54 patients with AMI, 26 patients with chronic stable angina(CSA), and 43 normal healthy subjects. In patients with AMI, LV function was measured by 2D-echocardio-graphy. Eighteen AMI patients were reassessed at 1 year. BMSC concentration was higher in patients with AMI(mean peak value: 7.04±6.27 cells/μL), than in patients with CSA(3.80±2.12 cells/μL, P=0.036) and in healthy controls(1.87±1.52 cells/μL, P< 0.001). At multivariable analysis statin use(P< 0.001), primary percutaneous intervention(P=0.048) and anterior AMI(P=0.05) were the only independent predictors of increased BMSC mobilization after AMI. In the 28 patients without subsequent acute coronary events reassessed at 1 year follow-up,CD34+cell concentration was an independent predictor of global and regional improvement of LV function(r=0.52, P=0.004 and r=-0.41, P=0.03, respectively). Conclusion: AMI is followed by enhanced spontaneous mobilization of BMSC, in particular, in patients on statin therapy and following a primary percutaneous intervention. More importantly persistent spontaneous mobilization of BMSC might contribute to determine a more favourable post-AMI remodelling.
文摘OBJECTIVES:We sought to determine the association between patent foramen ovale(PFO), atrial septal aneurysm(ASA), and stroke prospectively in a unselected population sample. BACKGROUND: The disputed relationship between PFO and stroke reflects methodologic weaknesses in studies using invalid controls, unblinded transesophageal echocardiography examinations, and data that are unadjusted for age or comorbidity. METHODS: The use of transesophageal echocardiography to identify PFO was performed by a single echocardiographer using standardized definitions in 585 randomly sampled, Olmsted County(Minnesota) subjects age 45 years or older participating in the Stroke Prevention: Assessment of Risk in a Community(SPARC) study. RESULTS: A PFO was identified in 140(24.3% ) subjects and ASA in 11(1.9% ) subjects. Of the 140 subjects with PFO, 6(4.3% ) had an ASA; of the 437 subjects without PFO, 5 had an ASA(1.1% , two-sided Fisher exact test, p=0.028). During a median follow-up of 5.1 years, cerebrovascular events(cerebrovascular disease-related death, ischemic stroke, transient ischemic attack) occurred in 41 subjects. After adjustment for age and comorbidity, PFO was not a significant independent predictor of stroke(hazard ratio 1.46, 95% confidence interval 0.74 to 2.88, p=0.28). The risk of a cerebrovascular event among subjects with ASA was nearly four times higher than that in those without ASA(hazard ratio 3.72, 95% confidence interval 0.88 to 15.71, p=0.074). CONCLUSIONS: These prospective population-based data suggest that, after correction for age and comorbidity, PFO is not an independent risk factor for future cerebrovascular events in the general population. A larger study is required to test the putative stroke risk associated with ASA.
