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Jiunn-Jye Sheu (1), Hon-Kan Yip (2)

(1) Dept. of Surgery, (2) Dept. of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Taiwan

We hypothesized that combined therapy with extracorporeal shock wave (ECSW) and bone marrow-derived mesenchymal stem cells (BMDMSCs) offered an additional benefit as compared with each treatment modality alone in alleviating left ventricular (LV) dysfunction through enhancing angiogenesis, exerting cytokine/paracrine effects, and suppressing inflammatory response/oxidative stress.

Male mini-pigs, weighting 18-20 kg, were equally divided into group 1 (normal control), group 2 [AMI (by ligation of left anterior descending artery), group 3 (AMI- ECSW), group 4 (AMI-BMDMSC) and group 5 (AMI-ECSW- BMDMSC). The animals were sacrificed at day 60 after.

The baseline LV injection fraction (LVEF) did not differ among five groups (p>0.5). However, by day 60, the LVEF was highest in group 1 and lowest in group 2, higher in group 5 than in groups 3 and 4, and higher in group 3 than in group 4 (p<0.001), whereas the LV chamber size showed an opposite pattern of VLEF among the five groups (p<0.001). The cellular and protein levels of VEGF, CXCR4 and SDF-α in infarct area (IA) were progressively increased from groups 1 to 5 (all p<0.005). The small-vessel number and CD31 protein expression in IA were highest in groups 1 and 5, lowest in group 2, higher in group 4 than in group 3 (p<0.001). The protein (MMP-9, TNF-1α and NF-κB, oxidized protein) and cellular (CD14+, CD40+) biomarkers in IA were highest in group 2 and lowest group 1, lower in group 5 than in groups 3 and 4, and lower in group 4 than in group 3 (all p<0.001).


Combined therapy is superior to either one alone for improving LVEF and inhibiting LV remodeling mainly through regulating angiogenesis and inflammation/oxidative stress.
محمد رضا جودکی
  • شهریور 16, 1393
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