Effect of intramyocardial injection of erytropetin stimulated autologus bone marrow cells on myocardial perfusion using 99mТC-MIBI spect in long-term
https://doi.org/10.20538/1682-0363-2018-4-171-179
Abstract
Purpose. To evaluate the changes of myocardial perfusion using 99mТс-MIBI single-photon emission computed tomography (SPECT) after the intramyocardial implantation of erythropoietin preconditioned autologous bone marrow cells (ABMC) in laser channels during coronary artery disease (CAD) surgery.
Materials and methods. Randomized study of 40 patients (mean age 58.0 ± 6.9, 9 females) with diffuse and (or) distal right coronary artery disease (RCA). Patients of the study group (n = 23) underwent coronary artery bypass grafting (CABG) of the left coronary artery (LCA) system and intramyocardial implantation of erythropoietin preconditioned ABMC in the left ventricular (LV) inferior wall. Patients of the control group (n = 17) underwent CABG of the LCA system only. 99mТс-MIBI SPECT performed 1–2 days before and 12 months after surgery.
Results. In study group after 12-month follow-up the summed stress score in a typical RCA supply area (SSSRCA) improved from 7.0 [5.5; 10.5] to 4.0 [1.0; 5.5] (p <0.01), summed rest score (SRSRCA) improved from 3.0 [0.0; 7.0] to 1.0 [0.0; 3.5] (p <0.01), and summed different score (SDSRCA) improved from 3.0 [1.0; 4.0] to 1.0 [0.0; 2.0] (p = 0.03). Control group patients after 12-month follow-up showed significant improvement of SSS RCA only – from 8.0 [6.0; 12.0] to 5.0 [4.0; 7.0] (p <0.01).
Conclusion. After 12-month follow-up in patients with diffuse and (or) distal RCA disease, the procedure of intramyocardial implantation of the erythropoietin preconditioned ABMC in laser channels is demonstrated to be safe and induces the improvement of myocardial perfusion.
About the Authors
A. M. ChernyavskiyRussian Federation
Chernyavskiy Alexander M., DM, Professor, Head of the Сenter of Аorta, Сoronary and Рeripheral Аrtery Surgery
15, Rechkunovskaya Str., Novosibirsk, 630055
A. V. Fomichev
Russian Federation
Fomichev Alexey V., PhD, Сardiovascular Surgeon, Department of Aorta and Coronary Artery Surgery
15, Rechkunovskaya Str., Novosibirsk, 630055
N. A. Nikitin
Russian Federation
Nikitin Nikita A., Radiologist, Radiology Department
15, Rechkunovskaya Str., Novosibirsk, 630055
O. V. Poveshchenko
Russian Federation
Poveschenko Olga V., PhD, Head of the Laboratory of Cell Technologies
15, Rechkunovskaya Str., Novosibirsk, 630055
J. E. Kareva
Russian Federation
Kareva Yuliya E., PhD, Сardiovascular Surgeon, Department of Aorta and Coronary Artery Surgery
15, Rechkunovskaya Str., Novosibirsk, 630055
K. K. Gulyaeva
Russian Federation
Gulyaeva Kseniya K., PhD Student, Department of Aorta and Coronary Artery Surgery
15, Rechkunovskaya Str., Novosibirsk, 630055
S. M. Minin
Russian Federation
Minin Stanislav M., PhD, Head of the Radioisotope Diagnosis Department
15, Rechkunovskaya Str., Novosibirsk, 630055
References
1. Oganov R.G., Maslennikova G.Ya. Mortality from cardiovascular and other chronic non-communicable diseases among the working Russian population. Kardiovaskulyarnaya terapiya i profilaktika – Cardiovascular Therapy and Prevention. 2002; 1 (3): 4–8 (in Russ.).
2. Chernyavsky A.M., Karaskov A.M., Mironenko S.P., Kovlyakov V.A. Surgical correction of multifocal atherosclerosis. Byulleten' sibirskogo otdeleniya Rossiyskoy akademii meditsinskikh nauk – The Bulletin of Siberian Branch of Russian Academy of Medical Sciences. 2006; 26 (2): 126–131 (in Russ.).
3. Simonenko V.В., Borisov I.A., Bletkin A.N., Zakharov S.V., Dalinin V.V. Revascularization of myocardium: coronary artery bypass grafting or stenting? Klin. med. – Klin. med. 2008; 86 (3): 13–17 (in Russ.).
4. Bokeriya L.A., Stupakov I.N., Samorodskaya I.V. Evaluation of the effectiveness of myocardial revascularization methods in randomized studies. Byulleten’ NTSSSKH im. A.N. Bakuleva RAMN «Serdechno-sosudistyye zabolevaniya». 2001; 2 (5): 16–49 (in Russ.).
5. Davydenko V.V., Gritsenko V.V., Afanasyev B.V., Matyukov A.A., Mayorov N.V., Lapekin S.V., Roshchupkin C.C. Use of autologous bone marrow cells to improve myocardial perfusion in surgical treatment of patients with valvular defect heart. Geny i kletki – Genes and Cells. 2011; 6 (3): 60–66 (in Russ.).
6. Romanov Yu.A., Smirnov V.N. Stem cells and cardiac regeneration. Kardiologicheskij Vestnik. 2007; 2 (2): 61–63 (in Russ.).
7. Klopsch C., Furlani D., Gäbel R., Li W., Pittermann E., Ugurlucan M. et al. Intracardiac injection of erythropoietin induces stem cell recruitment and improves cardiac functions in a rat myocardial infarction model. J. Cell Mol. Med. 2009; 13 (4): 664–679.
8. Dimitrova K.R., Leitman I.M. Intramyocardial transplantation of endothelial progenitor cells and erythropoietin: a new scope for the treatment of cardiovascular disease. J. Surg. Res. 2013; 183 (2): 550–552. DOI: 10.1016/j.jss.2012.05.010.
9. Verberne H.J., Acampa W., Anagnostopoulos C., Ballinger J., Bengel F., De Bondt P. et al. EANM procedural guidelines for radionuclide myocardial perfusion imaging with SPECT and SPECT/CT: 2015 revision. Eur. J. Nucl. Med. Mol. Imaging. 2015; 42 (12): 1929–1940. DOI: 10.1007/s00259-015-3139-x.
10. Herrmann J.L., Abarbanell A.M., Weil B.R., Wang Y., Wang M., Tan J., Meldrum D.R. Cell-based therapy for ischemic heart disease: a clinical update. Ann. Thorac. Surg. 2009; 88 (5): 1714–1722. DOI: 10.1016/j.athoracsur.2009.05.079.
11. Abdel-Latif A., Bolli R., Tleyjeh I.M., Montori V.M., Perin E.C., Hornung C.A. et al. Adult bone marrow-derived cells for cardiac repair: a systematic review and meta-analysis. Arch. Intern. Med. 2007; 28 (10): 989–997.
12. Hamano K., Nishida M., Hirata K., Mikamo A., Li T.S., Harada M. et al. Local implantation of autologous bone marrow cells for therapeutic angiogenesis in patients with ischemic heart disease: clinical trial and preliminary results. Jpn. Circ. J. 2001; 65 (9): 845–847.
13. Beeres S.L., Bax J.J., Dibbets P., Stokkel M.P., Zeppenfeld K., Fibbe W.E. et al. Effect of intramyocardial injection of autologous bone marrow-derived mononuclear cells on perfusion, function, and viability in patients with drug-refractory chronic ischemia. J. Nucl. Med. 2006; 47 (4): 574–580.
14. Tse H.F., Thambar S., Kwong Y.L., Rowlings P., Bellamy G., McCrohon J. et al. Prospective randomized trial of direct endomyocardial implantation of bone marrow cells for treatment of severe coronary artery diseases (PROTECT-CAD trial). Eur. Heart J. 2007; 28 (24): 2998–3005.
15. Grigoryan A.S., Kruglyakov P.V. Spontaneous malignant transformation of multipotent mesenchymal stromal cells in culture: does it actually occur? Geny i kletki – Genes and Cells. 2009; 4 (4): 78–82 (in Russ.).
Review
For citations:
Chernyavskiy A.M., Fomichev A.V., Nikitin N.A., Poveshchenko O.V., Kareva J.E., Gulyaeva K.K., Minin S.M. Effect of intramyocardial injection of erytropetin stimulated autologus bone marrow cells on myocardial perfusion using 99mТC-MIBI spect in long-term. Bulletin of Siberian Medicine. 2018;17(4):171-179. (In Russ.) https://doi.org/10.20538/1682-0363-2018-4-171-179