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ABSTRACT: Aims: The haemodynamic effect of mitral valve (MV) repair using multiple MitraClips® (MC) has not been investigated. The aim of the study was to evaluate the stress performance of MV repair with MC. Methods and results: Twenty consecutive patients (77±7 years, 13 men [65%]) after implantation of >2 MitraClips® were subsequently evaluated with dobutamine stress echocardiography (DSE). After MC implantation, mean transmitral pressure gradient (TPG) (3.3±0.8 mmHg vs. 4.0±0.6 mmHg; p<0.001) and mitral valve orifice area (2.9±0.3 cm2 vs. 3.9±0.4 cm2; p<0.001) were significantly increased during DSE showing a physiological behaviour effect of the MV. LVEF (41±18% vs. 46±21%; p<0.001) and systolic pulmonary artery pressure (42±11 mmHg vs. 44±12 mmHg; p=0.014) increased significantly. The degree of MR was stable during stress (p=0.68). At linear regression, only baseline peak TPG was related to stress mean TPG (p<0.001; Beta 0.816; 95% CI: 0.368-0.918). Conclusions: MV repair using MitraClips® should be performed with the aim of maximal reduction of MR degree. MV repair using MC may not lead to pathological degrees of MV stenosis. Although the TPG is significantly increased during stress, it never reaches pathological levels and is always accompanied by a significant increase in MVOA. The degree of residual MR remains unchanged during maximal pharmacological stress.
EuroIntervention: journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology 01/2013; · 3.29 Impact Factor
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Ibrahim Akin,
Stephan Kische,
Lylia Paranskaya,
Henrik Schneider,
Tim C Rehders,
Ulrich Trautwein,
Gökmen R Turan,
Dietmar Bänsch,
Olga Thiele,
Dimitar Divchev, Ilkay Bozdag-Turan,
Jasmin Ortak,
Gunther Kundt,
Christoph A Nienaber,
Hüseyin Ince
[show abstract]
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ABSTRACT: BACKGROUND: Transcatheter aortic valve implantation (TAVI) has been established as a treatment option for inoperable patients with symptomatic aortic valve stenosis. However, patients suffer frequently from conduction disturbances after TAVI. METHODS: Baseline, procedural as well as surface and intracardiac ECG parameters were evaluated for patients treated with TAVI and a comparison between patients requiring pacemaker with those not suffering from relevant conduction disorders were done. RESULTS: TAVI was successfully in all patients (n=45). Baseline surface and intracardiac ECG recording revealed longer PQ (197.1+/-51.2 msec versus 154.1+/-32.1 msec; p<0.001), longer AH (153.6+/-43.4 msec versus 116.1+/-31.2 msec; p<0.001) and HV interval (81.7+/-17.8 msec versus 56.8+/-8.5 msec; p<0.001) in patients with need for a pacemaker (n=23) versus control group (n=22); furthermore, 7-day follow-up analysis showed a higher prevalence of new left bundle branch block (LBBB) (87.0% versus 31.9%; p<0.001). Multivariate analysis revealed that only new LBBB, QRS duration >120 msec and a PQ interval >200 msec immediately (within 60 minutes) after implantation of the aortic valve were predictors for high-grade (type II second-degree and third-degree) AV block. Other clinical parameters as well as baseline electrocardiographic parameters had no impact on critical conduction delay. CONCLUSION: Cardiac conduction disturbances are common after TAVI. The need for pacing after TAVI is predictable by surface ECG evaluation immediately (within 60 minutes) after the procedure.
BMC Cardiovascular Disorders 10/2012; 12(1):87. · 1.52 Impact Factor
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Liliya Paranskaya,
Giuseppe D'Ancona, Ilkay Bozdag-Turan,
Ibrahim Akin,
Stephan Kische,
Gökmen R Turan,
Dimitar Divchev,
Tim C Rehders,
Henrik Schneider,
Jasmin Ortak,
Christoph A Nienaber,
Hüseyin Ince
[show abstract]
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ABSTRACT: Aims: Compare mid-term outcomes after MitraClip® implantation for severe mitral regurgitation (MR) in patients categorised in different logistic EuroSCORE (LES) groups. Methods and results: MitraClip was implanted in 85 patients (78±6 years, 48 men [56.5%]) with severe symptomatic MR. Baseline characteristics, perioperative results, mid-term survival, major adverse cerebrovascular and cardiac events (MACCE), and re-hospitalisation were compared in patients with LES <20% (n=30) and ≥20% (n=55). Overall LES was 24±12 (range 2.5-56.3) and STS-score 12±7 (range 1.2-31.2). Overall procedural success rate was 96.5% with an in-hospital mortality rate of 3.5%. Echocardiographic and clinical follow-up confirmed similar mean transmitral pressure gradient (p=0.13), MR degree (p=0.48), and NYHA Class (p=0.93). Estimated six-month survival and freedom from composite endpoint was 80.7%/77.1% in LES ≥ 20% and 90.8/86.6% in LES<20% group, respectively (p= 0.014; p=0.018). Multivariate analysis determined LES ≥20% (OR=8.1; 95% CI 1.002-65.186), mean transmitral gradient after intervention (OR 2.5; 95% CI 1.267-5.131) and residual MR (OR=5.1; 95% CI 1.464-17.946) as predictors for overall mortality. Conclusions: LES is a good predictor of perioperative results, and follow-up adverse outcomes after MitraClip implantation are significantly influenced by the preoperative risk profile. The presence of residual MR immediately after MitraClip therapy can exacerbate the occurrence of MACCE.
EuroIntervention: journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology 09/2012; 8(5):571-8. · 3.29 Impact Factor
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Liliya Paranskaya,
Giuseppe D'Ancona, Ilkay Bozdag-Turan,
Ibrahim Akin,
Stephan Kische,
Gökmen R Turan,
Tim Rehders,
Henrik Schneider,
Bernd Westphal,
Ralf Birkemeyer,
Christoph A Nienaber,
Hüseyin Ince
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ABSTRACT: BACKGROUND: The objective of this study was to compare outcomes of surgical repair (SR) vs MitraClip (MC) implantation for severe mitral regurgitation (MR). METHODS: A retrospective analysis of patients treated within a single institution was performed. Patients had EuroSCORE [European System for Cardiac Operative Risk Evaluation] < 20%, left ventricular ejection fraction ≥45%, and grade 3+/4+ MR. RESULTS: Fifty patients (24 [48%] MC group, 26 [52%] SR group) with EuroSCORE 7.9 ± 5.6 were included. The MC group included 24 (48%) and the SR group 26 (52%) patients. Patients in the MC group had a significantly more complex comorbid profile (P < 0.001). Successful MC placement was in 22 patients (91.7%) and SR in 26 (100%). At discharge, no patient had grade 3+/4+ MR. There were no in hospital or 30-day deaths. At follow-up (mean 526 ± 398 days), further mitral valve surgery was necessary in 1 (3.8%) patient in the SR group and in 2 (8.3%) patients in the MC group (P = 0.26). One-year freedom from composite end point (death, stroke, myocardial infarction, major bleeding, cardiac rehospitalization) was 75.5% (SR 83% vs MC 67%; P = 0.18). Degree of residual MR Degree of residual MR immediately after the procedure was equally distributed in both groups (P = 0.13) and the sole independent determinant for composite outcome (odds ratio, 16.9; P = 0.024). CONCLUSIONS: MC in nonsurgical candidates and SR in surgical patients showed similar perioperative and follow-up outcomes at an institution experienced with both techniques. Neither MC nor SR were independently related to outcome whenever similar degrees of acute correction with minimal residual MR were achieved. However, these findings should be interpreted within the selection biases and the numerical limitations of the present study.
The Canadian journal of cardiology 08/2012; · 3.36 Impact Factor
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ABSTRACT: OBJECTIVES: We undertook this study to investigate the mid-term clinical results after MitraClip® implantation and the impact of post-repair mitral MV function and anatomy on survival and outcome composite endpoint in high-risk patients. BACKGROUND: Percutaneous mitral valve (MV) repair is a potential treatment option for high-risk patients with severe mitral regurgitation (MR). METHODS: MitraClip® was implanted in patients with symptomatic MR rejected to conventional surgery. Differences between patients that survived at follow-up and patients deceased were tested. A stepwise Cox multivariate analysis was performed to identify independent predictors for composite endpoint of mortality, cardiac re-hospitalization, re-intervention, and major cerebro-vascular and cardiac events. RESULTS: A total of 85 consecutive patients [78±6 years, 48 (56.5%) men] with severe MR were included. There was no operative mortality while in-hospital mortality was 3.5% (n=3) and 30-day mortality 4.7% (n=4). Follow-up was 211±173 days. Survival and composite endpoint-free survival at one year were 71% and 55%. Multivariate analysis revealed that residual MR immediately after MitraClip® placement (OR 7.4; 95% CI 2.3-23.7) and preoperative MV gradient (OR 2.7; 95% CI 1.5-5.0) were predictors for composite endpoint. Chronic obstructive pulmonary disease (OR 8.3; 95% CI 1.9-37.1) was an additional predictor for composite endpoint. CONCLUSION: MitraClip® is a valid tool with favorable outcomes in high-risk patients. The degree of residual MR seems to impact on follow-up composite endpoint outcome. An optimal correction of MR after MitraClip placement could be advocated to optimize the benefits of the procedure and minimize the risk of adverse outcomes. © 2012 Wiley Periodicals, Inc.
Catheterization and Cardiovascular Interventions 08/2012; · 2.29 Impact Factor
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ABSTRACT: The results of the Endovascular Valve Edge-to-Edge Repair Study (EVEREST) II trial have demonstrated that percutaneous mitral valve repair using the MitraClip in high-risk patients was associated favourable outcomes. However, commonly accepted contraindications for the standard MitraClip procedure include extensively prolapsed valves and flail leaflets. We report on the management of a patient not amenable to standard interventional procedure.
The Canadian journal of cardiology 07/2012; · 3.36 Impact Factor
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Ilkay Bozdag-Turan,
R Goekmen Turan,
Lylia Paranskaya,
Nicole S Arsoy,
C Hakan Turan,
Ibrahim Akin,
Stephan Kische,
Jasmin Ortak,
H Schneider,
S Ludovicy,
Tina Hermann,
Giuseppe D'Ancona,
Serkan Durdu,
A Ruchan Akar,
Hueseyin Ince,
Christoph A Nienaber
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ABSTRACT: Bone marrow-derived circulating progenitor cells (BM-CPCs) in patients with coronary heart disease are impaired with respect to number and functional activity. However, the relation between the functional activity of BM-CPCs and the number of diseased coronary arteries is yet not known. We analyzed the influence of the number of diseased coronary arteries on the functional activity of BM-CPCs in peripheral blood (PB) in patients with ischemic heart disease (IHD).
The functional activity of BM-CPCs was measured by migration assay and colony forming unit in 120 patients with coronary 1 vessel (IHD1, n = 40), coronary 2 vessel (IHD2, n = 40), coronary 3 vessel disease (IHD3, n = 40) and in a control group of healthy subjects (n = 40). There was no significant difference of the total number of cardiovascular risk factors between IHD groups, beside diabetes mellitus (DM), which was significantly higher in IHD3 group compared to IHD2 and IHD1.
The colony-forming capacity (CFU-E: p < 0.001, CFU-GM: p < 0.001) and migratory response to stromal cell-derived factor 1 (SDF-1: p < 0.001) as well as vascular endothelial growth factor (VEGF: p < 0001) of BM-CPCs were reduced in the group of patients with IHD compared to control group. The functional activity of BM-CPCs was significantly impaired in patients with IHD3 as compared to IHD1 (VEGF: p < 0.01, SDF-1: p < 0.001; CFU-E: p < 0.001, CFU-GM: p < 0.001) and to IHD2 (VEGF: p = 0.003, SDF-1: p = 0.003; CFU-E: p = 0.001, CFU-GM: p = 0.001). No significant differences were observed in functional activity of BM-CPCs between patients with IHD2 and IHD1 (VEGF: p = 0.8, SDF-1: p = 0.9; CFU-E: p = 0.1, CFU-GM: p = 0.1). Interestingly, the levels of haemoglobin AIc (HbAIc) correlated inversely with the functional activity of BM-CPCs (VEGF: p < 0.001, r = -0.8 SDF-1: p < 0.001, r = -0.8; CFU-E: p = 0.001, r = -0.7, CFU-GM: p = 0.001, r = -0.6) in IHD patients with DM.
The functional activity of BM-CPCs in PB is impaired in patients with IHD. This impairment increases with the number of diseased coronary arteries. Moreover, the regenerative capacity of BM-CPCs in ischemic tissue further declines in IHD patients with DM. Furthermore, monitoring the level of BM-CPCs in PB may provide new insights in patients with IHD.
Journal of Translational Medicine 07/2012; 10:143. · 3.41 Impact Factor
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Liliya Paranskaya,
Giuseppe D'Ancona, Ilkay Bozdag-Turan,
Ibrahim Akin,
Stephan Kische,
Gökmen R Turan,
Dimitar Divchev,
Tim Rehders,
Bernd Westphal,
Jochen Schubert,
Christoph A Nienaber,
Hüseyin Ince
[show abstract]
[hide abstract]
ABSTRACT: OBJEKTIVES: The purpose of this study was to compare outcomes using standard clipping (SC) (1-2 clips) or multiple clipping (MC) (>2 clips). BACKGROUND: MitraClip® implantation using MC has been proposed to treat severe mitral regurgitation (MR) in high-risk patients. METHODS AND RESULTS: A tailored strategy was used implanting as many clips as required to eliminate MR. A total of 85 consecutive patients [78±6 years, 48 men (56.5%) ] with MR (grade 3+ or 4+) were included. EuroSCORE was 24±12 (2.5-56.3) and STS-score 12±7 (1.2-31.2). SC was used in 61 (71.8%) and MC in 24 (28.2%) patients. Patients in MC group had larger mitral valve (MV) annuli (p=0.025), MV orifice areas (MVOA) (p=0.01), and MR degree (p=0.005). Successful clip placement was achieved in 82 patients (96.5%). At discharge, no patient had grade 4+ MR. MR 3+ presented in 4 patients (7.0%) in the SC group and in 1 (4.5%) in the MC group (p=0.72). There were 3 (3.5%) in hospital deaths. Follow up (211±173 days, range 4-652) echocardiography confirmed similar MVOA (p=0.83) and MV gradients (p=0.54) in the both groups. At linear regression there was no independent correlation between clips number and postoperative MVOA/gradient. One-year survival was 71.1% without difference between groups (p=0.74). CONCLUSION: Although the hemodynamic and anatomical basis of MR may differ, every procedure should aim at eliminating MR. In some patients this goal can be achieved using MC with minimized risk of MV stenosis if preoperative anatomy/mechanism of MV regurgitation are adequately assessed. © 2012 Wiley Periodicals, Inc.
Catheterization and Cardiovascular Interventions 06/2012; · 2.29 Impact Factor
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Ilkay Bozdag-Turan,
R Goekmen Turan,
Sophie Ludovicy,
Ibrahim Akin,
Stephan Kische,
Henrik Schneider,
Tim C Rehders,
C Hakan Turan,
Nicole S Arsoy,
Tina Hermann,
Liliya Paranskaya,
Jasmin Ortak,
Peter Kohlschein,
Manuela Bastian,
Kurtulus Sahin,
Christoph A Nienaber,
Hueseyin Ince
[show abstract]
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ABSTRACT: Autologous bone marrow cell transplantation (BMCs-Tx) is a promising novel option for treatment of cardiovascular disease. In this study we analyzed whether intracoronary autologous freshly isolated BMCs-Tx have beneficial effects on cardiac function in patients with ischemic heart disease (IHD).
In this prospective nonrandomized study we treated 12 patients with IHD by freshly isolated BMCs-Tx by use of point of care system and compared them with a representative 12 control group without cell therapy. Global ejection fraction (EF) and infarct size area were determined by left ventriculography.Intracoronary transplantation of autologous freshly isolated BMCs led to a significant reduction of infarct size (p < 0.001) and an increase of global EF (p = 0.003) as well as infarct wall movement velocity (p < 0.001) after 6 months follow-up compared to control group. In control group there were no significant differences of global EF, infarct size and infarct wall movement velocity between baseline and 6 months after coronary angiography. Furthermore, we found significant decrease in New York Heart Association (NYHA) as well as significant decrease of B-type natriuretic peptide (BNP) level 6 months after intracoronary cell therapy (p < 0.001), whereas there were no significant differences in control group 6 months after coronary angiography.
These results demonstrate that intracoronary transplantation of autologous freshly isolated BMCs by use of point of care system is safe and may lead to improvement of cardiac function in patients with IHD.
Registration number: ISRCTN54510226.
BMC Research Notes 04/2012; 5:195.
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Ilkay Bozdag-Turan,
R Goekmen Turan,
C Hakan Turan,
Sophie Ludovicy,
Ibrahim Akin,
Stephan Kische,
Nicole S Arsoy,
Henrik Schneider,
Jasmin Ortak,
Tim Rehders,
Tina Hermann,
Liliya Paranskaya,
Peter Kohlschein,
Manuela Bastian,
A Tulga Ulus,
Kurtulus Sahin,
Hueseyin Ince,
Christoph A Nienaber
[show abstract]
[hide abstract]
ABSTRACT: Bone marrow-derived circulating progenitor cells (BM-CPCs) in patients with coronary heart disease are impaired with respect to number and mobilization. However, it is unknown whether the mobilization of BM-CPCs depends on the number of diseased coronary arteries. Therefore, in our study, we analysed the correlation between the diseased coronary arteries and the frequency of CD34/45+ BM-CPCs in peripheral blood (PB) in patients with ischemic heart disease (IHD).
The frequency of CD34/45+ BM-CPCs was measured by flow cytometry in 120 patients with coronary 1 vessel (IHD1, n = 40), coronary 2 vessel (IHD2, n = 40), coronary 3 vessel disease (IHD3, n = 40) and in a control group of healthy subjects (n = 40). There was no significant difference of the total number of cardiovascular risk factors between IHD groups, beside diabetes mellitus (DM), which was significantly higher in IHD3 group compared to IHD2 and IHD1 groups.
The frequency of CD34/45+ BM-CPCs was significantly reduced in patients with IHD compared to the control group (CD34/45+; p < 0.001). The frequency of BM-CPCs was impaired in patients with IHD3 compared to IHD1 (CD34/45+; p < 0.001) and to IHD2 (CD34/45+; p = 0.001). But there was no significant difference in frequency of BM-CPCs between the patients with IHD2 and IHD1 (CD34/45+; p = 0.28). In a subgroup we observed a significant negative correlation between levels of hemoglobin AIc (HbAIc) and the frequency of BM-CPCs (CD34/45+; p < 0.001, r = -0.8).
The frequency of CD34/45+ BM-CPCs in PB is impaired in patients with IHD. This impairment may augment with an increased number of diseased coronary arteries. Moreover, the frequency of CD34/45+ BM-CPCs in ischemic tissue is further impaired by diabetes in patients with IHD.
Cardiovascular Diabetology 11/2011; 10:107. · 3.35 Impact Factor
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R Goekmen Turan,
C Hakan Turan, Ilkay Bozdag-Turan,
Jasmin Ortak,
Ibrahim Akin,
Stephan Kische,
Henrik Schneider,
Tilo Kleinfeldt,
Tim C Rehders,
Mathias Rauchhaus,
Esther Adolph,
Shwan Amen,
Tina Hermann,
Sedat Yokus,
Micheal Brehm,
Stephan Steiner,
Kurtulus Sahin,
Christoph A Nienaber,
Hueseyin Ince
[show abstract]
[hide abstract]
ABSTRACT: The influence of the number of diseased coronary arteries on the mobilization of CD133/45(+) bone marrow-derived circulating progenitor cells (BM-CPCs) in peripheral blood (PB) in patients with ischemic heart disease (IHD) was analyzed.
Mobilization of CD133/45(+) BM-CPCs by flow cytometry was measured in 120 patients with coronary 1 vessel (IHD1, n=40), coronary 2 vessel (IHD2, n=40), and coronary 3 vessel disease (IHD3, n=40), and in a control group (n=40). The mobilization of CD133/45(+) BM-CPCs was significantly reduced in patients with IHD compared to the control group (P<0.001). The mobilization of CD133/45(+) BM-CPCs was impaired in patients with IHD3 compared to IHD1 (P<0.001) and to IHD2 (P<0.001). But there was no significant difference in mobilization of CD133/45(+) BM-CPCs between the patients with IHD2 and IHD1 (P=0.35). Moreover, we found significantly reduced CD133/45(+) cell mobilization in patients with a high SYNTAX-Score (SS) compared to a low SS (P<0.001) and an intermediate SS (P<0.001). In subgroup analyzes, we observed a significantly negative correlation between levels of hemoglobin A(1c) and the mobilization of CD133/45(+) BM-CPCs (P=0.001, r=-0.6).
The mobilization of CD133/45(+) BM-CPCs in PB is impaired in patients with IHD. This impairment might augment with increased number of diseased coronary arteries. Moreover, mobilization of CD133/45(+) BM-CPCs in ischemic tissue is further impaired by diabetes in patients with IHD.
Circulation Journal 08/2011; 75(11):2635-41. · 3.77 Impact Factor
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Ramazan Gökmen Turan, Ilkay Bozdag-Turan,
Jasmin Ortak,
Ibrahim Akin,
Stephan Kische,
Henrik Schneider,
Tim Christopher Rehders,
Cem Hakan Turan,
Mathias Rauchhaus,
Tilo Kleinfeldt,
Tuschar Chatterjee,
Kurtulus Sahin,
Christoph A Nienaber,
Hüseyin Ince
[show abstract]
[hide abstract]
ABSTRACT: We analyzed in the present study the influence of intracoronary autologous freshly isolated bone marrow cells transplantation (BMCs-Tx) on cardiac function in patients with acute myocardial infarction (AMI).
The 32 patients with AMI were enrolled in this prospective nonrandomized study to either freshly isolated BMC-Tx or to a control group without cell therapy. Global left ventricular ejection fraction (LVEF) and the size of infarct area were determined by left ventriculography. We observed in patients with autologous freshly isolated BMCs-Tx at 6 months follow up a significant reduction of infarct size as compared to control group. Moreover, we found a significant increase of LVEF as well as infarct wall movement velocity at 6 months follow up in cell therapy group as compared to control group. In the control group there was no significant difference of LVEF, infarct size and infarct wall movement velocity between baseline and 6 months after AMI.
These results demonstrate for the first time that intracoronary transplantation of autologous freshly isolated BMCs by use of a point of care system is safe, and may lead to improvement of cardiac function in patients with AMI.
Circulation Journal 01/2011; 75(3):683-91. · 3.77 Impact Factor
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Ramazan Gökmen Turan, Ilkay Bozdag-Turan,
Jasmin Ortak,
Ibrahim Akin,
Stephan Kische,
Henrik Schneider,
Cem Hakan Turan,
Tim Christopher Rehders,
Mathias Rauchhaus,
Tilo Kleinfeldt,
Ester Adolph,
Micheal Brehm,
Sedat Yokus,
Stephan Steiner,
Kurtulus Sahin,
Christoph A Nienaber,
Hüseyin Ince
[show abstract]
[hide abstract]
ABSTRACT: Cell therapy is a promising novel option for treatment of cardiovascular disease. Because the role of bone marrow-derived circulating progenitor cells (BM-CPCs) after cell therapy is less clear, we analyzed in this randomized, controlled study the influence of intracoronary autologous freshly isolated bone marrow cell transplantation (BMC-Tx) by using a point-of-care system on cardiac function and on the mobilization of BM-CPCs in patients with ischemic heart disease (IHD). Fifty-six patients with IHD were randomized to either receive freshly isolated BMC-Tx or a control group that did not receive cell therapy. Peripheral blood concentrations of CD34/45(+) and CD133/45(+) CPCs were measured by flow cytometry pre-, immediately post-, and at 3, 6, and 12 months postprocedure in both groups. Global ejection fraction and the size of infarct area were determined by left ventriculography. We observed in patients with IHD after intracoronary transplantation of autologous freshly isolated BMCs-Tx at 3 and 12 months follow-up a significant reduction of the size of infarct area and increase of global ejection fraction as well as infarct wall movement velocity. The mobilization of CD34/45(+) and CD133/45(+) BM-CPCs significantly increased at 3, 6, and 12 months after cell therapy when compared with baseline in patients with IHD, although no significant changes were observed between pre- and immediately postintracoronary cell therapy administration. In the control group without cell therapy, there was no significant difference of CD34/45(+) and CD133/45(+) BM-CPCs mobilization between pre- and at 3, 6, and 12 months postcoronary angiography. Intracoronary transplantation of autologous freshly isolated BMCs by using a point-of-care system in patients with IHD may enhance and prolong the mobilization of CD34/45(+) and CD133/45(+) BM-CPCs in peripheral blood and this might increase the regenerative potency in IHD.
Stem cells and development 12/2010; 20(9):1491-501. · 4.15 Impact Factor
