eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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vol. 18
Original paper

Transcoronary stem cell transfer and evolution of infarct-related artery atherosclerosis: evaluation with conventional and novel imaging techniques including Quantitative Virtual Histology (qVH)

Wladyslaw Dabrowski
1, 2
Lukasz Tekieli
1, 2, 3
Adam Mazurek
2, 3
Magdalena Lanocha
R. Pawel Banys
Krzysztof Zmudka
1, 2
Marcin Majka
Wojciech Wojakowski
Michal Tendera
Piotr Musialek
2, 3

Department of Interventional Cardiology, Jagiellonian University Institute of Cardiology, Krakow, Poland
John Paul II Hospital, Krakow, Poland
Department of Cardiac and Vascular Diseases, Jagiellonian University, Institute of Cardiology, John Paul II Hospital, Krakow, Poland
St. Adalbert’s Hospital, Poznan, Poland
Department of Radiology, John Paul II Hospital, Krakow, Poland
Jagiellonian University Department of Transplantation, Krakow, Poland
Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
Adv Interv Cardiol 2022; 18, 4 (70): 483–495
Online publish date: 2023/02/06
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It has been suggested that infarct-related artery (IRA) atherosclerosis progression after stem cell transcoronary administration might represent a stem-cell mediated adverse effect.

To evaluate, using conventional (quantitative coronary angiography, QCA, intravascular ultrasound – IVUS) and novel (quantitative virtual histology – qVH) tools, evolution of IRA atherosclerosis following transcoronary stem cell transfer.

Material and methods:
QCA, IVUS, VH-IVUS and qVH were performed in 22 consecutive patients (4 women) aged 59 years (data provided as median) undergoing a distal-to-stent infusion of 2.21 × 106 CD34+CXCR4+ autologous bone marrow cells via a cell delivery-dedicated perfusion catheter at anterior AMI day 7. Imaging was repeated at 12 months. This was a substudy of Myocardial Regeneration by Intracoronary Infusion of Selected Population of Stem Cells in Acute Myocardial Infarction (REGENT) Trial (NCT00316381).

18.2% subjects showed absence of distal-to-stent angiographic/IVUS atherosclerotic lesion(s) at baseline and no new lesion(s) at 12-months. In the remaining cohort, there were 28 lesions by QCA (32 by IVUS) at baseline and no new lesion(s) at follow-up. Three fibroatheromas evolved (2 to calcified fibroatheroma and 1 to a fibrocalcific lesion); other plaques maintained their stable (low-risk) phenotypes. Diameter stenosis of QCA-identified lesions was 29.5 vs. 26.5% (p = 0.012, baseline vs. 12-months). Gray-scale IVUS showed reduction in area stenosis (33.8 vs. 31.0%, p = 0.004) and plaque burden (66.27 vs. 64.56%, p = 0.009) at 12-months. Peak fibrotic plaque content increased from 70.41% to 75.0% (p = 0.004). qVH peak confluent necrotic core area and minimal fibrous cap thickness remained stable (0.64 vs. 0.59 mm2, p = 0.290, and 0.15 vs. 0.16 mm, p = 0.646).

This study, using a range of classic and novel imaging techniques, indicates lack of any stimulatory effect of transcoronary stem cell transfer on coronary atherosclerosis. Whether, and to what extent, a moderate reduction in plaque burden and stenosis severity at 12-months results from optimized pharmacotherapy and/or stem cell transfer requires further elucidation.


stem cells, progenitor cells, transcoronary administration, atherosclerosis

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