Hematopoietic stem cell (HSC) redistribution for cardiac repair following acute myocardial infarction (AMI)
Bibliographic record
Abstract
Controversy surrounds the role of HSC in repairing cardiac damage. In some animal studies, intracoronary or intramyocardial injection of autologous HSC contributed to new myocardial tissue following acute ischemic insult. The role of removing and reinjecting HSC is uncertain. HSC mobilized from the bone marrow circulate widely. We hypothesize that circulating HSC can localize to the area of revascularized cardiac damage following myocardial infarction and that HSC engraftment may have a beneficial effect on cardiac function. A pilot trial was conducted to study the feasibility and safety of HSC mobilization following AMI. Five patients that experienced large transmural anterior AMIs received 4 daily subcutaneous injections of 10 ug/kg G-CSF. At presentation, all patients had high-grade occlusions of a coronary artery that were successfully revascularized by percutaneous procedures. Baseline cardiac bloodflow (rubidium-82 PET) and myocardial metabolism (FDG-PET) studies confirmed transmural infarction. All patients started G-CSF within 7 days of AMI. Peripheral venous blood contained a median of 1.7 CD34(+)cells per ul (range 0.7 to 7.5) prior to G-CSF and a median of 75.6 CD34(+)cells per ul (range 72 to 91) following 4 days of G-CSF. There was no toxicity associated with G-CSF administration. The median baseline left ventricular ejection fraction (LVEj) was 30% (range 23–40%). Four weeks following HSC mobilization, the median LVEj increased to 40% (range 30 to 48%). This increase was clinically and statistically significant. Improvement in FDG uptake and a trend for increased perfusion were also observed. We conclude that administration of G-CSF following AMI is safe and mobilizes HSC into the circulation. G-CSF is associated with improved left ventricular function in a group of patients with large anterior wall AMI, a greater improvement than would be expected from historical controls. These findings suggest that G-CSF acts directly upon the heart to trigger recovery or G-CSF mobilized HSC migrate and engraft in the heart aiding recovery of cardiac function. A larger, randomized trial is planned to explore these issues.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".