Fujii Hiroko, Tomita Shinji, Nakatani Takeshi, Fukuhara Shinya, Hanatani Akihisa, Ohtsu Yoshinori, Ishida Michiko, Yutani Chikao, Miyatake Kunio, Kitamura Soichiro
Department of Organ Transplantation, National Cardiovascular Center, Osaka, Japan.
J Am Coll Cardiol. 2004 Apr 7;43(7):1299-305. doi: 10.1016/j.jacc.2003.09.061.
We investigated the feasibility of myocardial contrast echocardiography (MCE) to evaluate regional perfusion after bone marrow cell transplantation.
The myocardial microvessels improved by cell transplantation are too small to visualize with conventional angiography.
Fourteen mini-pigs from the Nippon Institute for Biological Science were used. The proximal left anterior descending coronary artery was ligated. One month later, nine pigs survived. Six pigs received autologous cell transplantation into the left ventricular anterior wall: bone marrow mononuclear cells (BMMNCs) (n = 3) and bone marrow stromal cells (BMSCs) (n = 3). The other three pigs received saline (control group, n = 3). The pigs were sacrificed one month later. Myocardial contrast intensity (MCI) with a contrast agent was measured using the SONOS 5500 system (Philips). Capillary density (CD) and MCI were measured at four areas: anteroseptum (nontransplanted infarct area), anterior wall (transplanted infarct area), septum (border zone), and lateral wall (normal). We compared the anteroseptum with the anterior wall by MCI and CD.
In the BMMNC and BMSC subsets, the CD of the anterior wall was higher than that of the anteroseptum (p < 0.001). There was a linear relation between MCI and CD (acoustic unit [AU2] = 0.234 CD + 0.010, r = 0.92, p < 0.001). At one month after cell transplantation, MCI of the anterior wall increased in the BMMNC and BMSC subsets (p < 0.05), although it did not change in the control group. The ratio of wall thickness (systole/diastole) in the transplanted infarct area was larger than that in the nontransplanted infarct area (p < 0.01).
Myocardial contrast echocardiography is useful to evaluate regional perfusion, which was enhanced by bone marrow cell transplantation.
我们研究了心肌对比超声心动图（MCE）评估骨髓细胞移植后局部灌注的可行性。
通过细胞移植改善的心肌微血管太小，无法用传统血管造影术可视化。
使用了日本生物科学研究所的14只小型猪。结扎左冠状动脉前降支近端。一个月后，9只猪存活。6只猪接受自体细胞移植到左心室前壁：骨髓单个核细胞（BMMNCs）（n = 3）和骨髓基质细胞（BMSCs）（n = 3）。另外3只猪接受生理盐水（对照组，n = 3）。一个月后处死这些猪。使用SONOS 5500系统（飞利浦）测量使用造影剂后的心肌对比强度（MCI）。在四个区域测量毛细血管密度（CD）和MCI：前间隔（未移植梗死区域）、前壁（移植梗死区域）、间隔（边界区域）和侧壁（正常）。我们通过MCI和CD比较前间隔和前壁。
在BMMNC和BMSC亚组中，前壁的CD高于前间隔（p < 0.001）。MCI与CD之间存在线性关系（声学单位[AU2] = 0.234 CD + 0.010，r = 0.92，p < 0.001）。细胞移植后1个月，BMMNC和BMSC亚组前壁的MCI增加（p < 0.05），而对照组未改变。移植梗死区域的壁厚（收缩期/舒张期）比值大于未移植梗死区域（p < 0.01）。
心肌对比超声心动图有助于评估局部灌注，骨髓细胞移植可增强局部灌注。
