Trans-endocardial delivery of progenitor cells to compromised myocardium using the “needle technique”and risk of myocardial injury

Drabik, Leszek; Mazurek, Adam; Dzieciuch-Rojek, Monika; Tekieli, Łukasz; Czyż, Łukasz; Kwiecień, Ewa; Kułaga, Aleksandra; Mikunda, Aleksandra; Chmiel, Jakub; Płazak, Wojciech; Rubiś, Paweł; Musiałek, Piotr

doi:10.5114/aic.2022.121033

Cited by 4 publications

(4 citation statements)

References 27 publications

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“…Thus, larger studies are required to corroborate our present findings. Furthermore, while there is no doubt that a parallel sham/placebo comparative cohort would be desirable [ 8 , 46 ], the sample size in our study of labelled cells did not justify a control sham/placebo group.…”

Section: Discussionmentioning

confidence: 95%

Infarct size and long-term left ventricular remodelling in acute myocardial infarction patients subjected to transcoronary delivery of progenitor cells

Czyż¹,

Tekieli²,

Miszalski−Jamka³

et al. 2022

pwki

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Introduction: Infarct size (IS) is a fundamental determinant of left-ventricular (LV) remodelling (end-systolic and end-diastolic volume change, ΔESV, ΔEDV) and adverse clinical outcomes after myocardial infarction (MI). Our prior work found that myocardial uptake of transcoronary-delivered progenitor cells is governed by IS.Aim: To evaluate the relationship between IS, stem cell uptake, and the magnitude of LV remodelling in patients receiving transcoronary administration of progenitor cells shortly after MI.Material and methods: Thirty-one subjects (age 36-69 years) with primary percutaneous coronary intervention (pPCI)-treated anterior ST-elevation MI (peak CK-MB 584 [181-962] U/l, median [range]) and sustained left ventricle ejection fraction (LVEF) ≤ 45% were studied. On day 10 (median) 4.3 × 10 6 (median) autologous CD34+ cells (50% labelled with 99m Tc-extametazime) were administered via the infarct-related artery (left anterior descending). ΔESV, ΔEDV, and mid circumferential myocardial strain (mCS) were evaluated at 24 months.Results: Infarct mass (cMRI) was 57 g. Cell label myocardial uptake (whole-body γ-scans) was proportional to IS (r = 0.62), with a median 2.9% uptake in IS 1 st tercile (≤ 45 g), 5.2% in 2 nd (46-76 g), and 6.7% in 3 rd (> 76 g) (p = 0.0006). Cell uptake in proportion to IS attenuated the IS-ΔESV (p = 0.41) and IS-ΔEDV (p = 0.09) relationship. At 24 months, mCS improved in IS 2 nd tercile (p = 0.028) while it showed no significant change in smaller (p = 0.87) or larger infarcts (p = 0.58).Conclusions: This largest human study with labelled CD34+ cell transplantation shortly after MI suggests that cell uptake (proportional to IS) may attenuate the effect of IS on LV adverse remodelling. To boost this effect, further strategies should involve cell types and delivery techniques to maximize myocardial uptake.

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Section: Discussionmentioning

confidence: 95%

Infarct size and long-term left ventricular remodelling in acute myocardial infarction patients subjected to transcoronary delivery of progenitor cells

Czyż¹,

Tekieli²,

Miszalski−Jamka³

et al. 2022

pwki

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“…However, there is still a research gap in this field. Dravik et al. (2022) indicate the need to support “a better understanding of the causes, interlinkages, and impacts of environmental stressors on health and the environment.” The primary question concerns the relationship between the health system and public policies (environmental, research, etc.).…”

Section: Theoretical Foundation Of the Study And Research Gapmentioning

confidence: 99%

Managing health through environmental policies. Analysis for European Union countries

Postula,

Kluza,

Zioło

et al. 2024

CEMJ

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PurposeEnvironmental degradation resulting from human activities may adversely affect human health in multiple ways. Until now, policies aimed at mitigating environmental problems such as climate change, environmental pollution and damage to biodiversity have failed to clearly identify and drive the potential benefits of these policies on health. The conducted study assesses and demonstrates how specific environmental policies and instruments influence perceived human health in order to ensure input for a data-driven decision process.Design/methodology/approachThe study was conducted for the 2004–2020 period in European Union (EU) countries with the use of dynamic panel data modeling. Verification of specific policies' impact on dependent variables allows to indicate this their effectiveness and importance. As a result of the computed dynamic panel data models, it has been confirmed that a number of significant and meaningful relationships between the self-perceived health index and environmental variables can be identified.FindingsThere is a strong positive impact of environmental taxation on the health index, and the strength of this relationship causes effects to be observed in the very short term, even the following year. In addition, the development of renewable energy sources (RES) and the elimination of fossil fuels from the energy mix exert positive, although milder, effects on health. The reduction of ammonia emissions from agriculture and reducing noise pollution are other health-supporting factors that have been shown to be statistically valid. Results allow to identify the most efficient policies in the analyzed area in order to introduce those with the best results or a mix of such measures.Originality/valueThe results of the authors' research clearly indicate the health benefits of measures primarily aimed at improving environmental factors, such as environmental taxes in general. The authors have also discovered an unexpected negative impact of an increase in the share of energy taxes in total taxes on the health index. The presented study opens several possibilities for further investigation, especially in the context of the rapidly changing geopolitical environment and global efforts to respond to environmental and health challenges. The authors believe that the outcome of the authors' study may provide new arguments to policymakers pursuing solutions that are not always easily acceptable by the public.

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“…On the other hand, this type of cell implantation is not physiological and may be of limited value in terms of further cell survival. However, myocardial injections may cause myocardial damage [ 60 ]. Data from the Congestive Heart Failure Cardiopoietic Regenerative Therapy (CHART-1) trial indicated an association between an increase in the number of endomyocardial injections to deliver therapeutic cells and a reduction in the therapeutic effect of mesenchymal cell transplantation in patients with chronic ischemic heart failure [ 61 ].…”

Section: Routes Of Cell Administration To Myocardiummentioning

confidence: 99%

Single-photon emission computed tomography as a fundamental tool in evaluation of myocardial reparation and regeneration therapies

Tekieli¹,

Szot²,

Kwiecień³

et al. 2022

pwki

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Despite unquestionable progress in interventional and pharmacologic therapies of ischemic heart disease, the number of patients with chronic ischemic heart failure is increasing and the prognosis remains poor. Repair/restoration of functional myocardium through progenitor cell-mediated (PCs) healing and renovation of injured myocardium is one of the pivotal directions in biomedical research. PCs release numerous pro-angiogenic and anti-apoptotic factors. Moreover, they have self-renewal capability and may differentiate into specialized cells that include endothelial cells and cardiomyocytes. Uptake and homing of PCs in the zone(s) of ischaemic injury (i.e., their effective transplantation to the target zone) is an essential pre-requisite for any potential therapeutic effect; thus effective cell tracking is fundamental in pre-clinical and early clinical studies. Another crucial requirement in rigorous research is quantification of the infarct zone, including the amount of non-perfused and hypo-perfused myocardium. Quantitative and reproducible evaluation of global and regional myocardial contractility and left ventricular remodeling is particularly relevant in clinical studies. Using SPECT, our earlier work has addressed several critical questions in cardiac regenerative medicine including optimizing transcoronary cell delivery, determination of the zone(s) of myocardial cell uptake, and late functional improvement in relation to the magnitude of cell uptake. Here, we review the role of single-photon emission computed tomography (SPECT), a technique that offers high-sensitivity, quantitative cell tracking on top of its ability to evaluate myocardial perfusion and function on both cross-sectional and longitudinal bases. SPECT, with its direct relevance to routine clinical practice, is a fundamental tool in evaluation of myocardial reparation and regeneration therapies.

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Trans-endocardial delivery of progenitor cells to compromised myocardium using the “needle technique”and risk of myocardial injury

Cited by 4 publications

References 27 publications

Infarct size and long-term left ventricular remodelling in acute myocardial infarction patients subjected to transcoronary delivery of progenitor cells

Infarct size and long-term left ventricular remodelling in acute myocardial infarction patients subjected to transcoronary delivery of progenitor cells

Managing health through environmental policies. Analysis for European Union countries

Single-photon emission computed tomography as a fundamental tool in evaluation of myocardial reparation and regeneration therapies

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