Elsevier

JACC: Cardiovascular Imaging

Volume 4, Issue 12, December 2011, Pages 1284-1293
JACC: Cardiovascular Imaging

Original Research
CT for Evaluation of Myocardial Cell Therapy in Heart Failure: A Comparison With CMR Imaging

https://doi.org/10.1016/j.jcmg.2011.09.013Get rights and content
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Objectives

The aim of this study was to use multidetector computed tomography (MDCT) to assess therapeutic effects of myocardial regenerative cell therapies.

Background

Cell transplantation is being widely investigated as a potential therapy in heart failure. Noninvasive imaging techniques are frequently used to investigate therapeutic effects of cell therapies in the preclinical and clinical settings. Previous studies have shown that cardiac MDCT can accurately quantify myocardial scar tissue and determine left ventricular (LV) volumes and ejection fraction (LVEF).

Methods

Twenty-two minipigs were randomized to intramyocardial injection of phosphate-buffered saline (placebo, n = 9) or 200 million mesenchymal stem cells (MSC, n = 13) 12 weeks after myocardial infarction (MI). Cardiac magnetic resonance and MDCT acquisitions were performed before randomization (12 weeks after MI induction) and at the study endpoint 24 weeks after MI induction. None of the animals received medication to control the intrinsic heart rate during first-pass acquisitions for assessment of LV volumes and LVEF. Delayed-enhancement MDCT imaging was performed 10 min after contrast delivery. Two blinded observers analyzed MDCT acquisitions.

Results

MDCT demonstrated that MSC therapy resulted in a reduction of infarct size from 14.3 ± 1.2% to 10.3 ± 1.5% of LV mass (p = 0.005), whereas infarct size increased in nontreated animals (from 13.8 ± 1.3% to 16.5 ± 1.5%; p = 0.02) (placebo vs. MSC; p = 0.003). Both observers had excellent agreement for infarct size (r = 0.96; p < 0.001). LVEF increased from 32.6 ± 2.2% to 36.9 ± 2.7% in MSC-treated animals (p = 0.03) and decreased in placebo animals (from 33.3 ± 1.4% to 29.1 ± 1.5%; p = 0.01; at week 24: placebo vs. MSC; p = 0.02). Infarct size, end-diastolic LV volume, and LVEF assessed by MDCT compared favorably with those assessed by cardiac magnetic resonance acquisitions (r = 0.70, r = 0.82, and r = 0.902, respectively; p < 0.001).

Conclusions

This study demonstrated that cardiac MDCT can be used to evaluate infarct size, LV volumes, and LVEF after intramyocardial-delivered MSC therapy. These findings support the use of cardiac MDCT in preclinical and clinical studies for novel myocardial therapies.

Key Words

CMR
delayed contrast enhancement
Göttingen minipig
heart failure
MDCT
mesenchymal stem cell
myocardial infarction

Abbreviations and Acronyms

CMR
cardiac magnetic resonance
DCE
delayed contrast enhancement
HF
heart failure
LV
left ventricle/ventricular
LVEDV
left ventricular end-diastolic volume
LVEF
left ventricular ejection fraction
LVESV
left ventricular end-systolic volume
MBF
myocardial blood flow
MDCT
multidetector computed tomography
MI
myocardial infarction
MSC
mesenchymal stem cells

Cited by (0)

All authors have reported that they have no relationships relevant to the contents of this paper to disclose.