Document Detail

Infarct Size Determines Myocardial Uptake of CD34+ Cells in the Peri-Infarct Zone: Results from a Study of 99mTc-extamatazime-labeled Cells Visualization Integrated with Cardiac Magnetic Resonance Infarct Imaging.
MedLine Citation:
PMID:  23271789     Owner:  NLM     Status:  Publisher    
BACKGROUND: -Effective progenitor cell recruitment to ischemic injury zone is a prerequisite for any potential therapeutic effect. Cell uptake determinants in humans with recent MI are not defined. We tested the hypothesis that myocardial uptake of autologous CD34(+) cells delivered intracoronary after recent MI is related to LVEF and infarct size (IS). METHODS AND RESULTS: -Thirty-one subjects (age 36-69 years, 28 men) with pPCI-treated anterior STEMI and significant myocardial injury (peak TnI 138 [58-356ng/dL]; median [limits]) and sustained LVEF depression at ≤45%) were recruited. On day 10 [7-12], 4.3x10(6) [0.7-9.9x10(6)] (99m)Tc-extametazime-labeled autologous bone-marrow CD34(+) cells (activity 77 [45.9-86.7]MBq) were administered transcoronary (LAD). (99m)Tc-MIBI-SPECT prior to cell delivery showed 7 [2-11] (of 17) segments with definitely-abnormal/absent perfusion. Gadolinium late-enhanced infarct core (LGE(CORE)) mass was 21.7 [4.4-45.9]g and infarct border-zone mass (LGE(IBZ)) was 29.8 [3.9-60.2]g (full-width-at-half-maximum, FWHM, signal intensity thresholding algorithm). One hour after administration, 5.2% [1.7-9.9%] of labeled cells activity localized in the myocardium (whole-body planar γ-scan). Image fusion of labeled cells SPECT with LV perfusion SPECT or with cMRI infarct imaging indicated cell uptake in the peri-infarct zone. Myocardial uptake of labeled cells activity correlated in particular with LGE(IBZ) (r=0.84, p<0.0001) and with peak TnI (r=0.76, p<0.001); it also correlated with severely-abnormal/absent perfusion segments number (r=0.45, p=0.008 and LGE(CORE) (r=0.58 and r=0.84, p<0.0001) but not with echo-LVEF (r=-0.07, p=0.68) or GSPECT-LVEF (r=-0.28, p=0.16). The correlation with cMRI-LVEF was weak (r=-0.38, p=0.04). CONCLUSIONS: -This largest human study with labeled bone marrow CD34(+) cells transcoronary transplantation after recent STEMI found that myocardial cell uptake is determined by infarct size rather than LVEF, and it occurs preferentially in the peri-infarct zone.
Piotr Musialek; Lukasz Tekieli; Magdalena Kostkiewicz; Tomasz Miszalski-Jamka; Piotr Klimeczek; Wojciech Mazur; Wojciech Szot; Marcin Majka; R Pawel Banys; Danuta Jarocha; Zbigniew Walter; Maciej Krupinski; Piotr Pieniazek; Maria Olszowska; Krzysztof Zmudka; Mieczyslaw Pasowicz; Dean J Kereiakes; Wieslawa Tracz; Piotr Podolec; Wojciech Wojakowski
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-27
Journal Detail:
Title:  Circulation. Cardiovascular imaging     Volume:  -     ISSN:  1942-0080     ISO Abbreviation:  Circ Cardiovasc Imaging     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101479935     Medline TA:  Circ Cardiovasc Imaging     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
1 Jagiellonian University and John Paul II Hospital, Krakow, Poland;
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