Multi-modality imaging in the patients with myocardial infarction after coronary artery bypass graft and autologous bone marrow stem cell transplantation
10.3760/cma.j.issn.2095-2848.2017.06.001
- VernacularTitle:联合显像对冠状动脉搭桥术后不同时间点自体骨髓干细胞移植治疗心肌梗死的疗效评价
- Author:
Guoxiu LU
;
Shanhu HAO
;
Zhiguo WANG
;
Tong ZHANG
;
Huishan WANG
;
Guoxu ZHANG
- Keywords:
Myocardial infarction;
Stem cell transplantation;
Transplantation,autologous;
Coronary artery bypass;
Position-emission tomography;
Tomography,X-ray computed;
Coronary angiography;
Magnetic resonance imaging
- From:
Chinese Journal of Nuclear Medicine and Molecular Imaging
2017;37(6):321-325
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the value of multi-modality imaging (PET/CT+CAG+CMRI) in post myocardial infract (MI) patients followed coronary artery bypass graft (CABG) and autologous bone marrow stem cell (BMSC) therapy.Methods A total of 43 patients with MI (27 males, 16 females, age range: 47-72 years) were prospectively enrolled in the year 2012 between January and December.All patients underwent CABG+BMSC transplantation and were divided into 3 groups according to the time interval between two treatments (group 1: 0-3 d;group 2: 4-14 d;group 3: 15-30 d).All patients were orderly scanned with CMRI, PET/CT (13N-NH3·H2O/18F-FDG) and CAG at different time-points pre-/post-treatment.The quantitative parameters included vascular stenosis degree(VSD), LVEF, percentage size of infarction (PSI), the number of segments in mismatched myocardial perfusion/metabolic and the K value for radioactive distribution grading.One-way analysis of variance and the least significant difference t test were used to compare parameters before and after treatment in the same group and among three different groups.Results Regarding PET/CT diagnostic efficacy of abnormal myocardial segments, the sensitivity, specificity, positive predictive value and negative predictive value were 95.4%(540/566), 87.3%(144/165), 96.3%(540/561) and 84.7%(144/170), respectively.After CABG and BMSC transplantation treatments for 12 months, VSD decreased significantly((69.1±9.5)%;F=12.854, P<0.05), comparing with the baseline ((74.8±7.9)%;t=3.074, P<0.05).Comparing to the baseline, LVEF in 3 groups increased slightly(F values: 0.906,0.298,0.059, all P>0.05).PSI of patients in group 2 decreased greatly after 12 months treatment ((35.70±12.59)%;F=3.792, t values:-2.916-4.059, all P<0.05).K values for radioactive distribution grade decreased obviously after 1 month and 12 months treatment comparing to the baseline (11.79±1.87,12.39±2.35,14.05±2.15;F=4.212, t values:-4.619,-0.989, all P<0.05).Number of myocardial perfusion/metabolic abnormal segments in group 2 after 1 month treatment was lower comparing to the baseline and 24 months treatment (10.17±0.66, 12.92±0.99, 14.17±1.21;F=3.543, t values:-2.146,-2.898, all P<0.05).The PSI, mismatched segments and K values post-treatment were not significantly different between group 1 and 3 (F values: 0.093-1.364, all P>0.05).Conclusions Multi-modality imaging may be used for accurately detecting abnormal myocardium and predicting prognosis.CABG+BMSC therapy during day 4-14 post-MI may temporarily improve perfusion and metabolism in viable myocardium, but the long term prognosis seemed not be improved.
