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Master thesis

Imagerie multimodale en SPECT, PET et IRM de la thérapie cellulaire cardiaque : Résultats d'une étude clinique nancéenne utilisant les cellules médullaires mononucléées

Abstract : Objective: our study's purpose was to assess the informations provided by different cardiac imaging technics (Sestamibi-SPECT, FDG-PET and MRI) in the baseline staging and post-operative follow-up of patients included in a cliinical study of cell therapy with Bone Marrow Stem Cells (MNCs). Methods: 14 patients referred to coronary artery by pass grafting (CABG) with >2-month old myocardial infarctlon (MI) and for whom a screening Sestamibi-SPECT had given evidence of severely damaged myocardium (< 50% uptake under nitrate), were randomized between a cell therapy group (n=7; CABG and injection of MNCs within areas of sever MI) and a control group (n=7; CABG alone). Changes in myocardial perfusion, metabolism and function were assessed upto 6 months by Sestamibi-SPECT, 18F-fluorodesoxyglucose-PET and cardiac MRI. Results : a post-therapeutic enhancement in the perfusion of MI areas was documented in cell therapy group (difference in Sestamibi uptake between 6-months and baseline : +6,8±5,4% ; p=0,01) and not in control group (+1,O±4,3%). However, this perfusion enhancement was significant (> 9%) in only 3 cell therapy patients, who ail had : (i) signs ofresidual ischemia at baseline (Sestamibi/FDG miss-match), (ii) concomitant 6-month improvements in the thickening of MI areas but (iii) surprising bypass dysfunctions at grafting sites. Conclusion: when added tobypass grafting, cell therapy with MNCs is associated with an enhanced perfusion within the areas of chronic and sever MI, but mainly in case of persisting ischemia at baseline and with a high incidence of early by pass dysfunction.
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Master thesis
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https://hal.univ-lorraine.fr/hal-01732793
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Submitted on : Wednesday, March 14, 2018 - 3:19:05 PM
Last modification on : Monday, October 19, 2020 - 11:10:25 AM
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  • HAL Id : hal-01732793, version 1

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Nicolas Didot. Imagerie multimodale en SPECT, PET et IRM de la thérapie cellulaire cardiaque : Résultats d'une étude clinique nancéenne utilisant les cellules médullaires mononucléées. Sciences du Vivant [q-bio]. 2009. ⟨hal-01732793⟩

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