Multiple imaging evaluation on the therapeutic efficacy of coronary artery bypass graft combined with autologous stem cell transplantation for myocardial infarction
10.3969/j.issn.2095-4344.2017.33.014
- VernacularTitle:联合显像在冠脉搭桥联合干细胞移植治疗心肌梗死疗效评估中的价值
- Author:
xiu Guo LU
1
;
hu Shan HAO
;
guo Zhi WANG
;
Tong ZHANG
;
shan Hui WANG
;
xu Guo ZHANG
Author Information
1. 解放军沈阳军区总医院
- From:
Chinese Journal of Tissue Engineering Research
2017;21(33):5332-5338
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND: Stem cells are still controversial for the treatment of old myocardial infarction. Multimodal imaging evaluation is one of the key points in the study of stem cell transplantation, which can evaluate the therapeutic efficacy of stem cell transplantation from the perspective of molecular imaging. OBJECTIVE: To evaluate the therapeutic efficacy of coronary artery bypass graft (CABG) with different stem cell transplantation in patients with old myocardial infarction using multimodal imaging technology. METHODS: Sixty patients with old myocardial infarction were enrolled and randomly divided into three groups to receive CABG, CABG+autologous bone marrow stem cell transplantation (CABG+BMC) or CABG+autologous peripheral blood stem cell transplantation (CABG+PBSC), respectively. All the patients were scanned with gated PET/CT (13N-NH3?H2O/18F-FDG), echocardiography and coronary angiography at different time points orderly (at baseline, 1, 12 and 24 months after treatment). We compared the degree of coronary stenosis (%), left ventricular ejection fraction (LVEF), percentage of defect size with myocardial perfusion/metabolic abnormal radioactive distribution (A) and the ratio of defect area (R).RESULTS AND CONCLUSION: In the diagnosis of survival myocardial segments, the sensitivity, specificity, positive predictive value and negative predictive value for the gated PET/CT were 92.1%, 85.6%, 93.4% and 78.4%, respectively. After the above treatments, the extent of coronary stenosis decreased significantly in the three groups (P < 0.05), which was improved most at 1 month after treatment (P < 0.05). In the CABG+BMC and CABG+PBSC groups, the LVEF value increased significantly after treatment (P < 0.05). In the CABG+BMC group, the A value decreased significantly at 1 and 24 months after treatment as compared with the baseline (P < 0.05), and the A value was further decreased, indicating a significant difference at 12 and 24 months after treatment (P < 0.05). In the CABG+BMC group, the R value significantly decreased at 1 month after treatment compared with the baseline (P=0.019). To conclude, the multimodal imaging is better to evaluate the prognosis of patients undergoing CABG with different stem cell transplantation, which is beneficial for the selection of treatment and therapeutic evaluation in myocardial infarction patients. CABG combined with stem cell transplantation can improve the left ventricular function of patients in a short time, and CABG+BMC is superior to CABG+PBSC to improve the survived myocardial function in patients.
